Provider Demographics
NPI:1033717830
Name:POWELL, ARIATHNI PINACAS (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:ARIATHNI
Middle Name:PINACAS
Last Name:POWELL
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:ARIATHNI
Other - Middle Name:
Other - Last Name:PINACAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5761 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:SOCIAL CIRCLE
Mailing Address - State:GA
Mailing Address - Zip Code:30025-4705
Mailing Address - Country:US
Mailing Address - Phone:770-757-3256
Mailing Address - Fax:
Practice Address - Street 1:5761 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:SOCIAL CIRCLE
Practice Address - State:GA
Practice Address - Zip Code:30025-4705
Practice Address - Country:US
Practice Address - Phone:770-757-3256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD005701133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered