Healthcare Provider Details
I. General information
NPI: 1922745652
Provider Name (Legal Business Name): HEALING FAVOR NUTRITION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2022
Last Update Date: 05/15/2022
Certification Date: 05/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2330 SCENIC HWY S STE 203
SNELLVILLE GA
30078-3115
US
IV. Provider business mailing address
2330 SCENIC HWY S STE 203
SNELLVILLE GA
30078-3115
US
V. Phone/Fax
- Phone: 770-881-8651
- Fax:
- Phone: 770-881-8651
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MERCY
AREMU
Title or Position: OWNER
Credential: RD, LD
Phone: 770-881-8651