Individual
JENNIFER LYNN CASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1120 15TH ST # BA1565, AUGUSTA, GA 30912-0004
(706) 721-3202
Mailing address
1120 15TH ST # BA1565, AUGUSTA, GA 30912-0004
(706) 721-3202
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
LD006233
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5802258-DC10
BLUE CROSS BLUE SHIELD
GA
Enumeration date
10/12/2022
Last updated
10/12/2022
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