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General NPI Number Information
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NPI Number | 1780048330
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Entity Type | Organization
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Legal Business Name | CHEERFUL HABITS LLC
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 2470 WINDY HILL RD SE SUITE 300 PMB 5202
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City | MARIETTA
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State | GA
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Zip | 30067-8613
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Country | US
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Telephone | 770-861-9176
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Fax | 404-465-3496
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Provider Business Mailing Address
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Address Line | 2470 WINDY HILL RD SE SUITE 300 PMB 5202
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City | MARIETTA
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State | GA
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Zip | 30067-8613
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Country | US
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Telephone | 770-861-9176
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | LOICA MARC
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Credential | RD
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Telephone | 770-861-9176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 16028312
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License Number State | GA
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