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Individual

LASHAWNDA BEASLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDN, LD, CLC

Contact information

Practice address
8240 MILAM LOOP, FAIRBURN, GA 30213-4727
(804) 731-7701
Mailing address
PO BOX 801, TYRONE, GA 30290-0801

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01060753

Other

Enumeration date
09/25/2019
Last updated
04/05/2020
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