Individual
MELLISSA WILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, IBCLC
Contact information
Practice address
2209 SUNNY VALLEY CT, FORT MILL, SC 29707-7770
(864) 354-0786
Mailing address
2209 SUNNY VALLEY CT, FORT MILL, SC 29707-7770
(864) 354-0786
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
L-35546
SC
363L00000X
Nurse Practitioner
Primary
27625
SC
Other
Enumeration date
11/10/2018
Last updated
07/24/2023
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