Provider Demographics
NPI:1104275759
Name:PARKER, MOLLY (IBCLC, RLC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 WRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-2155
Mailing Address - Country:US
Mailing Address - Phone:404-803-2301
Mailing Address - Fax:
Practice Address - Street 1:2024 POWERS FERRY RD SE
Practice Address - Street 2:SUITE 201
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5011
Practice Address - Country:US
Practice Address - Phone:404-803-2301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-05
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN