Individual
ALYSSA STROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3025 BRECKINRIDGE BLVD STE 160, DULUTH, GA 30096-8985
(678) 447-6637
Mailing address
5051 STATION CIR, NORCROSS, GA 30071-4560
(678) 447-6637
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD005012
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD005012
RD STATE LICENSE
GA
Enumeration date
05/01/2020
Last updated
05/01/2020
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