Individual
LAURA CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLC
Contact information
Practice address
754 VIRGINIA CIR NE, ATLANTA, GA 30306-3712
(404) 561-5538
Mailing address
754 VIRGINIA CIR NE, ATLANTA, GA 30306-3712
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-151124
GA
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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