Individual
CANDACE L GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1245 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-1807
(706) 868-0389
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
L-303750
—
Other
Enumeration date
09/16/2021
Last updated
09/29/2021
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