Provider Demographics
NPI:1609482793
Name:EXPRESS YOURSELF, LLC
Entity Type:Organization
Organization Name:EXPRESS YOURSELF, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN IBCLC
Authorized Official - Phone:404-556-3206
Mailing Address - Street 1:5141 WELLSLEY BND
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5067
Mailing Address - Country:US
Mailing Address - Phone:404-556-3206
Mailing Address - Fax:
Practice Address - Street 1:5141 WELLSLEY BND
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5067
Practice Address - Country:US
Practice Address - Phone:404-556-3206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care