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Contact Information

ELIZABETH B REVILLA, MS, RD, LD, CSP
1547 CLIFTON RD NE
ATLANTA, GA30322-4008
 Phone: 404-785-1784
 Fax: 404-727-4828
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Pediatric

133VN1004X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for ELIZABETH B REVILLA · (Female)

NPI # 1265631436
Status Active
Credentials MS, RD, LD, CSP
Entity Individual
Enumeration date 07/17/2007
Last updated 07/17/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • GA License # LD002723
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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