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General NPI Number Information
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NPI Number | 1144976374
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Entity Type | Individual
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Provider Name | JUANITA AUDREY LYNN BARR RD, LD
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Gender | Female
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 06/12/2026
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Provider Practice Location Address
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Address Line | 352 UNIVERSITY AVE SW
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City | ATLANTA
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State | GA
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Zip | 30310-3630
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Country | US
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Telephone | 470-315-3301
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Fax |
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Provider Business Mailing Address
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Address Line | 503 N PARK LN
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City | MILTON
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State | GA
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Zip | 30004-4952
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Country | US
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Telephone | 470-315-3301
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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