Provider Demographics
NPI:1134711278
Name:DREAM BABY CAFE, LLC
Entity type:Organization
Organization Name:DREAM BABY CAFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:CPNP-PC, IBCLC
Authorized Official - Phone:678-925-8494
Mailing Address - Street 1:3875 STUTZ ST
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9037
Mailing Address - Country:US
Mailing Address - Phone:678-925-8494
Mailing Address - Fax:
Practice Address - Street 1:3875 STUTZ ST
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9037
Practice Address - Country:US
Practice Address - Phone:678-925-8494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty