Individual
KAYLA GEORGEWILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
610 CALISTOGA DR, BRANDON, MS 39047-4020
(601) 549-5152
Mailing address
610 CALISTOGA DR, BRANDON, MS 39047-4020
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1659
MS
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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