Individual
MRS. ANGELA MARIE VERGHESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(770) 683-3894
Mailing address
67 MARINA DR, NEWNAN, GA 30263-7455
(770) 683-3894
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
004544
GA
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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