Doctor Name: | LYDIA AULTMAN |
NPI Number: | 1114153277 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | REGISTERED DIETITIAN |
License Number: | 006433 |
Business Practice Address: | 1900 Tebeau St Waycross, GA - 315016357 |
Business Phone Number: | 9122874271 |
Business Fax Number: | 9123386400 |
Mailing Address: | 1900 Tebeau St, WAYCROSS |
State: | GA |
Postal Code: | 315016357 |
Phone Number: | 9122874271 |
Fax Number: | 9123386400 |
NPI Enumeration Date: | 06/03/2009 |
NPI Last Update Date: | 05/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 006433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |