Georgia Nutrition Provider Directory



Georgia Directory of Nutrition Professionals

Application

The Georgia Division of Public Health, Office of Nutrition is developing a Georgia Directory of Nutrition Professionals. This directory will be made available to health care providers and the public via the World Wide Web. If you are a licensed nutrition professional in Georgia and would like to be included in the directory, please complete all information fields in the table below that you would like published in the Georgia Directory of Nutrition Professionals. Please return completed form by email to khyurman@dhr.state.ga.us or fax to 404-657-2886.

Date application submitted: 8/29/2013

|Last Name | |

|First Name | |

|Credentials and Certifications (e.g., | |

|RD, LD, CDE, etc.) | |

|Organization/Company | |

|County of Practice | |

|Email | |

|Phone Number | |

|Web site | |

|Areas of Practice (e.g. pediatrics, | |

|sports nutrition, renal, etc.) | |

|Languages Spoken (other than | |

|English) | |

|Insurance Accepted (List | |

|specific providers and diseases when | |

|applicable) | |

Disclaimer: Please note that by completing and returning this form, you are authorizing the Georgia Department of Community Health, Division of Public Health (DPH), Office of Nutrition to make this information available to the public via the World Wide Web or other media. The DPH will publish this information along with notice to the public of the Georgia Dietetic Licensure Laws. DPH is not responsible for the content found on Web sites provided by the Georgia Directory of Nutrition Professionals. DPH does not endorse, recommend or sponsor any specific nutrition professionals or programs other than those administered by local public health districts operating under DPH.

For more information about the Georgia Directory of Nutrition Professionals, please contact the Office of Nutrition at 404-657-2884.

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