Individual
TRACEY LASHAE COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
139 RALPH MCGILL BLVD NE # 5, ATLANTA, GA 30308-3339
(404) 804-2997
Mailing address
139 RALPH MCGILL BLVD NE # 5, ATLANTA, GA 30308-3339
(404) 804-2997
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-12510959
—
GA
Enumeration date
09/11/2020
Last updated
09/11/2020
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