Provider Demographics
NPI:1376012047
Name:SCHEMBRI, BROOKE MICKLE (MPH, RD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:MICKLE
Last Name:SCHEMBRI
Suffix:
Gender:F
Credentials:MPH, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 DERRYDOWN WAY
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3815
Mailing Address - Country:US
Mailing Address - Phone:202-213-6201
Mailing Address - Fax:
Practice Address - Street 1:315 WINN WAY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2111
Practice Address - Country:US
Practice Address - Phone:404-299-9724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-25
Last Update Date:2018-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003613133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered