Provider Demographics
NPI:1790159291
Name:WALKER, ALEAH (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:ALEAH
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-7487
Mailing Address - Country:US
Mailing Address - Phone:770-256-0977
Mailing Address - Fax:
Practice Address - Street 1:225 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-7487
Practice Address - Country:US
Practice Address - Phone:770-256-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 133NN1002X
GA374J00000X
GALC000008174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No374J00000XNursing Service Related ProvidersDoula