Individual
STEPHANIE LIPSCOMBE SELASSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CN
Contact information
Practice address
255 SOUTHERLAND TER NE, ATLANTA, GA 30307-2301
(404) 919-5306
Mailing address
PO BOX 467563, ATLANTA, GA 31146-7563
(404) 919-5306
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
04/07/2016
Last updated
04/07/2016
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