Individual
MRS. ANGELA MICHELLE STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
103 MERCER DR STE B, DUBLIN, GA 31021-4257
(478) 274-3012
(478) 274-7719
Mailing address
105 E JACKSON ST, DUBLIN, GA 31021-6113
(478) 274-3012
(478) 274-7719
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
876892
GA
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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