Provider Demographics
NPI:1871852491
Name:KUZNIAK, KALI (RD, LD)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:
Last Name:KUZNIAK
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 1:145 APPLEBY DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-1748
Mailing Address - Country:US
Mailing Address - Phone:770-856-9986
Mailing Address - Fax:
Practice Address - Street 1:145 APPLEBY DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-1748
Practice Address - Country:US
Practice Address - Phone:770-856-9986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003818133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered