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General NPI Number Information
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NPI Number | 1144862749
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Entity Type | Individual
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Provider Name | VICTORIA BAIRD MS, RD, LD
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Gender | Female
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 1400 TULLIE RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-2309
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Country | US
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Telephone | 404-785-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 1824 DEFOOR AVE NW APT 5203
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City | ATLANTA
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State | GA
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Zip | 30318-3079
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | LD005344
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License Number State | GA
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