Individual
ANGELA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(706) 832-8699
Mailing address
619 S MARION AVE, LAKE CITY, FL 32025-5808
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
003723
GA
133V00000X
Registered Dietitian
Primary
728
SC
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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