Doctor Name: | EILEEN BRODY SHAW |
NPI Number: | 1003195900 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LC, LAPC |
License Number: | LD000428 |
Business Practice Address: | 4536 Barclay Dr Suite A Atlanta, GA - 303387145 |
Business Phone Number: | 7704588711 |
Business Fax Number: | 7704588640 |
Mailing Address: | 4536 Barclay Drive, Suite A ATLANTA |
State: | GA |
Postal Code: | 30338 |
Phone Number: | 7704588711 |
Fax Number: | 7704588640 |
NPI Enumeration Date: | 08/09/2011 |
NPI Last Update Date: | 08/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | LD000428 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |