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Organization

PEA POD NUTRITION AND LACTATION SUPPORT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALICIA C SIMPSON MS, RD, LD (EXECUTIVE DIRECTOR)
(678) 607-6052
Entity
Organization

Contact information

Practice address
1164 N HIGHLAND AVE NE, ATLANTA, GA 30306-3448
(678) 607-6052
Mailing address
PO BOX 5493, ATLANTA, GA 31107-0493
(678) 607-6052

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD004064
GA

Other

Enumeration date
06/13/2013
Last updated
06/13/2013
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