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General NPI Number Information
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NPI Number | 1588519037
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Entity Type | Organization
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Legal Business Name | LADYBUG LACTATION LLC.
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 225 MAIN ST UNIT 8
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City | HIRAM
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State | GA
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Zip | 30141-6100
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Country | US
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Telephone | 470-256-5777
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Fax | 678-623-8889
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Provider Business Mailing Address
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Address Line | PO BOX 8
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City | HIRAM
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State | GA
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Zip | 30141-0008
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Country | US
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Telephone | 470-256-5777
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Fax | 678-623-8889
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA FAITH ANDERSON CLACKUM
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Credential | IBCLC
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Telephone | 470-256-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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