| Doctor Name: | MARY LOUISE SLULLIVAN |
| NPI Number: | 1932329646 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D., LD, MA |
| License Number: | LD000433 |
| Business Practice Address: | 2361 Tobacco Rd Augusta, GA - 309069220 |
| Business Phone Number: | 7067934401 |
| Business Fax Number: | 7067904372 |
| Mailing Address: | 3522 Hilltop Dr, AUGUSTA |
| State: | GA |
| Postal Code: | 309065732 |
| Phone Number: | 7067968739 |
| Fax Number: | 7067966075 |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | LD000433 |
| 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 |