Individual
MELISSA FULLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, IBCLC
Contact information
Practice address
320 BROOK RD, MILTON, MA 02186
(201) 925-7267
Mailing address
320 BROOK RD, MILTON, MA 02186
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86093133
—
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Enumeration date
08/07/2018
Last updated
10/29/2024
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