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Individual
MRS. SHANNON M WIEDERHOLT
Active
Individual
MRS. SHANNON M WIEDERHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LDN,CDE
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1075
TN
Other
Enumeration date
02/19/2007
Last updated
07/08/2007
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