=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215665278
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY RAZZA RD, LDN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2022
-----------------------------------------------------
Last Update Date | 02/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2300 HOLCOMB BRIDGE RD STE 103-423
-----------------------------------------------------
City | ROSWELL
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30076-3481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-961-1778
-----------------------------------------------------
Fax | 888-356-0405
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2300 HOLCOMB BRIDGE RD STE 103-423
-----------------------------------------------------
City | ROSWELL
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30076-3481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-961-1778
-----------------------------------------------------
Fax | 888-356-0405
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------