Individual
MRS. VALERIE LIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD LD CDE
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0118
Mailing address
111 CYNDEE CIR, MARTINEZ, GA 30907-1338
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002057
GA
Other
Enumeration date
07/21/2010
Last updated
07/21/2010
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