Provider Demographics
NPI:1811753593
Name:GALUZZI, JILL MICHELE (RD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:MICHELE
Last Name:GALUZZI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 FLOWING SPRING TRL
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1867
Mailing Address - Country:US
Mailing Address - Phone:303-204-2705
Mailing Address - Fax:
Practice Address - Street 1:185 FLOWING SPRING TRL
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-1867
Practice Address - Country:US
Practice Address - Phone:303-204-2705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1005375133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered