Individual provider · NPI-1

Vista-Dale Hanley, R.D.

Dietitian, Registered · Columbus, GA

NPI number1902286727
StatusActive
Last updated in NPPESJun 6, 2015

Details

NPI
1902286727
Entity type
Individual (NPI-1)
Name
Ms. Vista-Dale Hanley
Credential
R.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jun 6, 2015
Last updated
Jun 6, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, RegisteredLD004220GAYes

Practice location

1448 Grove Park Dr
Apt 211
Columbus, GA 31904-1594

Phone 202-489-3570

Mailing address

1448 Grove Park Dr
Apt 211
Columbus, GA 31904-1594

Phone 202-489-3570

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