Provider Demographics
NPI:1528441466
Name:YOUR NUTRITION DIFFERENCE, LLC
Entity type:Organization
Organization Name:YOUR NUTRITION DIFFERENCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:ROBINSON
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:678-773-4416
Mailing Address - Street 1:510 STILLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-7342
Mailing Address - Country:US
Mailing Address - Phone:678-773-4416
Mailing Address - Fax:678-762-1487
Practice Address - Street 1:510 STILLHOUSE LN
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-7342
Practice Address - Country:US
Practice Address - Phone:678-773-4416
Practice Address - Fax:678-762-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD002049133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty