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General NPI Number Information
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NPI Number | 1184342628
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Entity Type | Organization
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Legal Business Name | YOURFIDE DIETITIAN LLC
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 2330 SCENIC HWY S STE 203
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 770-881-8651
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Fax |
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Provider Business Mailing Address
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Address Line | 2330 SCENIC HWY S STE 203
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 770-881-8651
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Fax |
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Authorized Official
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Title or Position | OWNER/DIETITIAN
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Name | MERCY AREMU
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Credential | RD
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Telephone | 770-881-8651
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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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