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Dietary & Nutritional Service Providers Dietitian, Registered Nutrition, Renal

Provider NPI: 1164470142

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 931-308-5719  Fax: --

Business Mailing Address:
Tel: 931-308-5719  Fax: --

NPI Information:
NPI: 1164470142
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y133VN1005XDietary & Nutritional Service Providers
Dietitian, Registered
Nutrition, Renal

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 133VN1005X





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