Individual
MARLEI BLAIR SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-0446
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-0446
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD005084
GA
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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