| Doctor Name: | MS. NATASHA LYNN MICKENS |
| NPI Number: | 1124369913 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD, LD, CDE |
| License Number: | LD003076 |
| Business Practice Address: | 1525 Clifton Rd Ne Suite 508 Atlanta, GA - 303224200 |
| Business Phone Number: | 4047782850 |
| Business Fax Number: | 4047782855 |
| Mailing Address: | 1525 Clifton Rd Ne, Suite 508 ATLANTA |
| State: | GA |
| Postal Code: | 303224200 |
| Phone Number: | 4047782850 |
| Fax Number: | 4047782855 |
| NPI Enumeration Date: | 03/05/2013 |
| NPI Last Update Date: | 03/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | LD003076 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| 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 |