Organization
MAMA MENTOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE GREEN RLC, IBCLC (RLC, IBCLC)
(706) 814-8083
Entity
Organization
Contact information
Practice address
175 EVERGREEN DR, MARTINEZ, GA 30907-1391
(706) 814-8083
Mailing address
175 EVERGREEN DR, MARTINEZ, GA 30907-1391
(706) 814-8083
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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