Individual
MRS. NICOLE SAMANTHA LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DBH, MPH, RD, LDN
Contact information
Practice address
2483 KALEY WALK NW, KENNESAW, GA 30152-2685
(770) 417-0512
Mailing address
2483 KALEY WALK NW, KENNESAW, GA 30152-2685
(770) 417-0512
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD004834
GA
Other
Enumeration date
11/03/2010
Last updated
08/28/2025
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