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Individual
MRS. TIA NICOLE WADE
Active
Individual
MRS. TIA NICOLE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBA, RD, LDN
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
DN004659
PA
Other
Enumeration date
04/27/2012
Last updated
04/08/2014
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