Individual
SUSAN BOEKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, IBCLC
Contact information
Practice address
1551 JENNINGS MILL RD UNIT 2900A, WATKINSVILLE, GA 30677-7254
(404) 725-0808
Mailing address
1551 JENNINGS MILL RD UNIT 2900A, WATKINSVILLE, GA 30677-7254
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD001047
GA
174N00000X
Lactation Consultant (Non-RN)
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Other
Enumeration date
09/07/2016
Last updated
01/12/2018
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