Individual
SHIELA COCHRAN RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1136 CLEVELAND AVE, EAST POINT, GA 30344-3618
(404) 466-6303
Mailing address
90 HANNAH WAY, PALMETTO, GA 30268-8549
(678) 326-2761
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD005188
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD005188
DIETITIANS LICENSE
GA
Enumeration date
05/11/2021
Last updated
05/11/2021
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