Most Relevant Information
Provider Data
| NPI Number: | 1003413162 |
| Provider Name: | DEANNA DAE CRISMON MS, RDN, LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | LD003645 |
Most Important Dates
| Enumeration Date: | 10/02/2020 |
| Last Updated: | 01/31/2024 |
Provider Practice Location
511 RAGSDALE TER
WOODSTOCK
GA
301884463
Practice Location Phone/Fax
| Phone: | 4047299415 |
| Fax: |
Provider Mailing Location
511 RAGSDALE TER
WOODSTOCK
GA
301884463
Provider Mailing Phone/Fax
| Phone: | 4047299415 |
| Fax: |