Individual
TERESA R MCCULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC, RLC
Contact information
Practice address
1120 15TH ST # BI7202, AUGUSTA, GA 30912-0004
(706) 721-8283
Mailing address
112 KINGS CHAPEL RD, AUGUSTA, GA 30907-4002
(706) 495-4036
(866) 390-0899
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
0000017
GA
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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