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General NPI Number Information
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NPI Number | 1164838173
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Entity Type | Individual
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Provider Name | SALLY BUTLER STIEGHAN R.D., L.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 222 14TH ST NE APT 213
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City | ATLANTA
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State | GA
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Zip | 30309-7681
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Country | US
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Telephone | 706-392-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 222 14TH ST NE APT 213
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City | ATLANTA
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State | GA
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Zip | 30309-7681
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Country | US
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Telephone | 706-392-0411
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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 | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | LD002495
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License Number State | GA
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