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General NPI Number Information
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NPI Number | 1780490433
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Entity Type | Organization
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Legal Business Name | JOYFUL LACTATION LLC
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Dates
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Enumeration Date | 12/07/2024
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Last Update Date | 09/06/2025
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Provider Practice Location Address
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Address Line | 413 PARKBROOK WAY
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City | CANTON
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State | GA
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Zip | 30114-5736
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Country | US
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Telephone | 770-580-2932
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4133
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City | CANTON
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State | GA
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Zip | 30114-0010
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Country | US
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Telephone | 770-354-1699
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Fax |
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Authorized Official
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Title or Position | RN, IBCLC
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Name | JACQUELINE SHEA COLLIER
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Credential |
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Telephone | 770-354-1699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number |
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License Number State |
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