Basic Information
| Provider Information | |||||||||
| NPI: | 1184014813 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAUBE | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.S., R.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 PEACHTREE NEST 1600 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303082246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048811294 | ||||||||
| FaxNumber: | 4048741249 | ||||||||
| Practice Location | |||||||||
| Address1: | 488 KENNESAW AVE NW | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300609409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704273075 | ||||||||
| FaxNumber: | 7704273261 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2015 | ||||||||
| LastUpdateDate: | 09/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | LD003179 | GA | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.