# MODERN MELANATED MOTHERS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356756944
- **Authorized official:** DENIECE WILLIAMS (LACTATION DOULA)
- **Authorized official phone:** (678) 520-0696

## Contact information

- **Practice address:** 109 WILLOWICK DR, LITHONIA, GA 30038-1725
- **Practice address phone:** (678) 520-0696
- **Mailing address:** 109 WILLOWICK DR, LITHONIA, GA 30038-1725

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | GA | Yes |

## Other

- **Enumeration date:** 06/23/2014
- **Last updated:** 06/23/2014