Organization
FLT FAMILY NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLORENCIA TARASIDO RD, IBCLC (DIETITIAN, LACTATION CONSULTANT)
(770) 380-2160
Entity
Organization
Contact information
Practice address
660 EVENING PINE LN, JOHNS CREEK, GA 30005-7417
(770) 380-2160
Mailing address
660 EVENING PINE LN, JOHNS CREEK, GA 30005-7417
(770) 380-2160
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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