Individual
ANNA SHUMWAY WAGSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2418 STOCKTON DR, MARIETTA, GA 30066-2142
(314) 737-3009
Mailing address
2418 STOCKTON DR, MARIETTA, GA 30066-2142
(314) 737-3009
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/07/2024
Last updated
12/07/2024
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