Individual
MRS. SHANNON M BLANKENSHIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS,IBCLC,RLC
Contact information
Practice address
3807 CLAIRMONT RD, CHAMBLEE, GA 30341-4911
(678) 475-4319
Mailing address
3131 GABLES WAY NE, ATLANTA, GA 30329-3238
(941) 920-3280
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11020108
GA
Other
Enumeration date
05/24/2011
Last updated
01/12/2012
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