Provider Demographics
NPI:1184407413
Name:DODSON, KERRI (NUTRITION THERAPIST)
Entity type:Individual
Prefix:MS
First Name:KERRI
Middle Name:
Last Name:DODSON
Suffix:
Gender:F
Credentials:NUTRITION THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 WILLOWPEG WAY
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-9112
Mailing Address - Country:US
Mailing Address - Phone:770-722-9580
Mailing Address - Fax:
Practice Address - Street 1:423 WILLOWPEG WAY
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-9112
Practice Address - Country:US
Practice Address - Phone:770-722-9580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach