Individual
HEIDI ROSE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
6768 APRICOT RD, BLACKSHEAR, GA 31516-5117
(912) 670-5241
Mailing address
6768 APRICOT RD, BLACKSHEAR, GA 31516-5117
(912) 670-5241
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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