Doctor Name: | MRS. ELISSAVETA B JOHNSON |
NPI Number: | 1134442122 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M. S., R.D., L.D. |
License Number: | LD003412 |
Business Practice Address: | 601 Dallas Hwy Villa Rica, GA - 301801202 |
Business Phone Number: | 7704563249 |
Business Fax Number: | 7704563351 |
Mailing Address: | 4012 Shaded Oasis Ln, VILLA RICA |
State: | GA |
Postal Code: | 301806966 |
Phone Number: | 7065065379 |
Fax Number: | |
NPI Enumeration Date: | 03/05/2010 |
NPI Last Update Date: | 03/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | LD003412 |
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 |