MISTY MULLINS CLACKUM

GAINESVILLE, GA
NPI1073944492
Former NameMISTY LEHE MULLINS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133VN1004X Dietitian, Registered, Nutrition, Pediatric
(Licence: GA  LD002340)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: GA  LD002340)
133VN1004X Dietitian, Registered, Nutrition, Pediatric
(Licence: TN  1250)
133VN1401X Dietitian, Registered, Nutrition, Pediatric Critical Care
(Licence: GA  LD002340)
Enumeration Date2013-12-11
Last Update Date2023-06-06
Business Address
Mrs. MISTY MULLINS CLACKUM RD, CSP, LDN
3869 BERKSHIRE RIDGE DR
GAINESVILLE, GA 30506-4560
Phone number: 423-284-5512
Mailing Address
Mrs. MISTY MULLINS CLACKUM RD, CSP, LDN
3869 BERKSHIRE RIDGE DR
GAINESVILLE, GA 30506-4560
Phone number: 423-284-5512