Individual
MRS. SHARON JOY MASCOE-MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD., LD.
Contact information
Practice address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(770) 719-6728
Mailing address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(770) 719-6728
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002930
GA
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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