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General NPI Number Information
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NPI Number | 1386532802
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Entity Type | Organization
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Legal Business Name | LITTLE BY LITTLE WELLNESS CLINIC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 4045 FIVE FORKS TRICKUM RD SW STE 130
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City | LILBURN
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State | GA
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Zip | 30047-2538
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Country | US
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Telephone | 404-860-2425
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Fax | 678-737-1726
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Provider Business Mailing Address
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Address Line | 887 RYAN LN SW
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City | LILBURN
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State | GA
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Zip | 30047-6642
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Country | US
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Telephone | 404-860-2425
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Fax | 678-737-1726
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Authorized Official
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Title or Position | OWNER
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Name | LATRINA WALDEN
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Credential | FNP, PMHNP
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Telephone | 404-860-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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