Provider Demographics
NPI:1164224408
Name:RAMIREZ ROCA, PAMELA R (IBCLC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:R
Last Name:RAMIREZ ROCA
Suffix:
Gender:X
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 MUSCAT CT
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-2476
Mailing Address - Country:US
Mailing Address - Phone:678-471-5675
Mailing Address - Fax:
Practice Address - Street 1:128 MUSCAT CT
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-2476
Practice Address - Country:US
Practice Address - Phone:678-471-5675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAL-311183174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN