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NPI 1326479262

NPI 1326479262 : LORI ANN SCHOLLE MS, RDN, LD, CBS : DECATUR, GA

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General NPI Number Information
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    NPI Number           |    1326479262
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    Entity Type          |    Individual 
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    Provider Name        |    LORI ANN SCHOLLE MS, RDN, LD, CBS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/03/2013
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    Last Update Date     |    12/03/2013
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Provider Practice Location Address
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    Address Line         |    615 PONCE DE LEON PL 
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    City                 |    DECATUR
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    State                |    GA
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    Zip                  |    30030-5108
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    Country              |    US
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    Telephone            |    404-566-4538
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    Fax                  |    404-566-4539
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1623 
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    City                 |    DECATUR
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    State                |    GA
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    Zip                  |    30031-1623
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    Country              |    US
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    Telephone            |    404-566-4538
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    Fax                  |    404-566-4538
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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       |    LD004058
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    License Number State |    GA
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Taxonomy #2
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    Taxonomy Code        |    133VN1004X
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    Taxonomy Name        |    Pediatric Nutrition Registered Dietitian
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    License Number       |    LD004058
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    License Number State |    GA
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Taxonomy #3
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    Taxonomy Code        |    174N00000X
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    Taxonomy Name        |    Lactation Consultant (Non-RN)
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    License Number       |    LD004058
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    License Number State |    GA
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