Provider Demographics
NPI:1750993655
Name:GWINNETT BREASTFEEDING, LLC
Entity type:Organization
Organization Name:GWINNETT BREASTFEEDING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY-ANN
Authorized Official - Middle Name:LATOYA
Authorized Official - Last Name:LOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:678-750-3121
Mailing Address - Street 1:3400 MCCLURE BRIDGE RD
Mailing Address - Street 2:BUILDING C, UNIT A
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3461
Mailing Address - Country:US
Mailing Address - Phone:678-750-3121
Mailing Address - Fax:
Practice Address - Street 1:3400 MCCLURE BRIDGE RD
Practice Address - Street 2:BUILDING C, UNIT A
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3461
Practice Address - Country:US
Practice Address - Phone:678-750-3121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty