Individual
MRS. CHELSEA ELIZABETH STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
138 REGISTRY LN, CANTON, GA 30115-2323
(770) 855-6678
Mailing address
138 REGISTRY LN, CANTON, GA 30115-2323
(770) 855-6678
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD005580
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86114183
COMMISSION ON DIETETIC REGISTRATION
—
01
—
LD005580
GEORGIA BOARD OF EXAMINERS OF LICENSED DIETITIANS
GA
Enumeration date
11/16/2020
Last updated
11/16/2020
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