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General NPI Number Information
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NPI Number | 1407315245
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Entity Type | Organization
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Legal Business Name | GOODNESS NUTRITION CENTER, LLC
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 08/07/2021
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Provider Practice Location Address
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Address Line | 761 ROSA DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-6613
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Country | US
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Telephone | 678-680-3261
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Fax | 833-441-1804
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Provider Business Mailing Address
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Address Line | 761 ROSA DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-6613
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Country | US
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Telephone | 678-680-3261
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Fax | 770-852-8648
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Authorized Official
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Title or Position | PRESIDENT
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Name | GLORIA AMPARO OCHOA-ANDIA
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Credential |
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Telephone | 678-680-3261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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