Individual
MS. CARISSA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
35 COLLIER RD NW STE 775, ATLANTA, GA 30309-1608
(404) 609-5060
Mailing address
2575 BETTY SUE DR, BUFORD, GA 30519-8204
(404) 901-2767
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86326814
GA
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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