Individual
ANN-MARISSA WASCHKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
915 GORDON AVE, THOMASVILLE, GA 31792-6614
(229) 228-2000
Mailing address
920 CAIRO RD, THOMASVILLE, GA 31792-4255
(229) 228-8800
(229) 228-8892
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD003194
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENSE
LD003194
GA
Enumeration date
12/18/2008
Last updated
01/27/2009
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