Individual
MALINI STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
23702 HWY 80 E, STATESBORO, GA 30461-0845
(912) 489-4090
(912) 764-8378
Mailing address
23702 HWY 80 E, STATESBORO, GA 30461-0845
(912) 489-4090
(912) 764-8378
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
727003
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
727003
COMISSION ON DIETETIC REGISTRATION
—
01
—
LD004103
GEORGIA BOARD OF LICENSED DIETITIANS
GA
Enumeration date
10/08/2018
Last updated
10/08/2018
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