Organization
LATCHED AT LAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAITLIN PETRILLO CLC (OWNER)
(631) 219-4992
Entity
Organization
Contact information
Practice address
136 BUCKLICK CREEK CT, SIMPSONVILLE, SC 29680-7449
(631) 219-4992
Mailing address
136 BUCKLICK CREEK CT, SIMPSONVILLE, SC 29680-7449
(631) 219-4992
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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