Melissa Brice, IBCLC, ALC

Individual provider Active NPI Lactation Consultant (Non-RN) · Dallas, GA

NPI 1003211079 · NPPES record last updated Nov 3, 2014

Key facts

NPI
1003211079
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Non-RN) 174N00000X
License
L 16318 (GA)
Practice address
430 Parson Rd
Dallas, GA 30157
Phone
(404) 401-3542
NPI assigned
Nov 3, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L 16318GAMDLactation Consultant (Non-RN)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L 16318 GA Yes

Addresses

Primary practice location

430 Parson Rd
Dallas, GA 30157

Mailing address

430 Parson Rd
Dallas, GA 30157
Phone (404) 401-3542

Other providers in Dallas, GA

All providers in Dallas, GA · Lactation Consultant (Non-RN) in Georgia

Sources for this page

Verify at the official NPI Registry.