Provider Demographics
NPI:1144494048
Name:GOODIN, MARGARET MARY NALLEY (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MARY NALLEY
Last Name:GOODIN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-4121
Mailing Address - Country:US
Mailing Address - Phone:229-938-7808
Mailing Address - Fax:
Practice Address - Street 1:623 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-4121
Practice Address - Country:US
Practice Address - Phone:229-938-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD002922133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered