IndividualActive
Cassady Black
NPI 1104433713 · Obesity and Weight Management Nutrition Registered Dietitian · Douglasville, GA
Provider details
- NPI number
- 1104433713
- Entity type
- Individual
- Primary specialty
- Obesity and Weight Management Nutrition Registered DietitianDietary & Nutritional Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- LD005540 (GA)
Mailing address
9543 Poplar Ct
Douglasville, GA 30135-1798
Registry dates
- Enumerated
- 2020-09-28
- Last updated
- 2020-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.