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General NPI Number Information
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NPI Number | 1740988997
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Entity Type | Organization
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Legal Business Name | OUTREACH FOR NUTRITION EDUCATION INC.
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 3883 ROGERS BRIDGED ROAD SUITE #304 B
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City | DULUTH
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State | GA
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Zip | 30097-2809
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Country | US
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Telephone | 678-687-9292
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Fax | 678-954-2554
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Provider Business Mailing Address
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Address Line | 5210 HARBURY LN
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City | SUWANEE
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State | GA
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Zip | 30024-7541
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Country | US
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Telephone | 678-687-9292
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Fax | 678-954-2554
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Authorized Official
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Title or Position | CEO
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Name | BEENA DESHPANDE
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Credential | REGISTERED DIETITIAN
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Telephone | 678-687-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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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 | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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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 | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number |
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License Number State |
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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 |
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License Number State |
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