Organization
DIETITIAN DISH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA ELLENBERG MS, RD, LDN, CSCS (REGISTERED DIETITIAN)
(704) 351-1552
Entity
Organization
Contact information
Practice address
2692 GALAHAD DR NE, ATLANTA, GA 30345-3627
(704) 351-1552
Mailing address
2692 GALAHAD DR NE, ATLANTA, GA 30345-3627
(704) 351-1552
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L008727
NORTH CAROLINA BOARD OF DIETETICS/NUTRITION
NC
01
—
LD004769
LICENSED DIETITIAN
GA
Enumeration date
12/29/2020
Last updated
07/24/2025
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