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General NPI Number Information
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NPI Number | 1740174564
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Entity Type | Individual
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Provider Name | DAPHNE WEST RD, LD, CLC
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Gender | Female
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1625 DAWNVILLE BEAVERDALE RD NE
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City | DALTON
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State | GA
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Zip | 30721-6814
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Country | US
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Telephone | 706-581-5533
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Fax |
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Provider Business Mailing Address
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Address Line | 425 CALIFORNIA ST STE 1400
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-2116
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Country | US
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Telephone | 212-589-2700
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Fax |
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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 | LD001830
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License Number State | GA
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