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General NPI Number Information
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NPI Number | 1316829641
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Entity Type | Individual
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Provider Name | TAMMY L. BOGDAN MS, RD, LD, CDCES
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Gender | Female
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 3211 WOLF CLAW CT
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City | MARIETTA
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State | GA
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Zip | 30062-1369
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Country | US
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Telephone | 678-485-6816
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Fax | 404-393-1539
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Provider Business Mailing Address
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Address Line | 3211 WOLF CLAW CT
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City | MARIETTA
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State | GA
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Zip | 30062-1369
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Country | US
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Telephone | 678-485-6816
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Fax | 404-393-1539
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | LD002311
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number | LD002311
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number | LD002311
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LD002311
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License Number State | GA
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