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1053166298
STEPHANIE LODGE
ATLANTA, GA
NPI
1053166298
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171400000X
Additional Taxonomies
133NN1002X Nutritionist Nutrition, Education
Enumeration Date
2024-04-22
Last Update Date
2024-04-22
Business Address
MS. STEPHANIE LODGE
2417 CHASTAIN DR NE # 2417
ATLANTA, GA 30342-4157
Phone number: 610-864-4344
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Mailing Address
MS. STEPHANIE LODGE
2417 CHASTAIN DR NE # 2417
ATLANTA, GA 30342-4157
Phone number: 610-864-4344
Copy