Provider Demographics
NPI:1013260660
Name:RZEZNIK, MARIA J (RD, LD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:J
Last Name:RZEZNIK
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 1:2155 CAMBERLEY PL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-1894
Mailing Address - Country:US
Mailing Address - Phone:770-597-7974
Mailing Address - Fax:
Practice Address - Street 1:1275 SHILOH RD NW
Practice Address - Street 2:STE 3030
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7186
Practice Address - Country:US
Practice Address - Phone:770-597-7974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist