Provider Demographics
NPI:1053775056
Name:SAWAYA, MICHELLE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SAWAYA
Suffix:
Gender:
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 KIMBERLY LN NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2225
Mailing Address - Country:US
Mailing Address - Phone:216-904-6772
Mailing Address - Fax:
Practice Address - Street 1:600 KIMBERLY LN NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-2225
Practice Address - Country:US
Practice Address - Phone:216-904-6772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD005565133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered