Healthcare Provider Details

I. General information

NPI: 1730510199
Provider Name (Legal Business Name): FRANCOISE MAILLET RD, CSG, LD, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE 3 RD FLOOR, BLDG A
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

1365 CLIFTON RD NE 3 RD FLOOR, BLDG A
ATLANTA GA
30322-1013
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4991
  • Fax:
Mailing address:
  • Phone: 404-778-4991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberLD001639
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: