Individual
KENRESE THERESA CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CNS, LDN
Contact information
Practice address
46088 SALTMARSH CT, LEXINGTON PARK, MD 20653-2879
(404) 397-3009
Mailing address
4344 FAWN LN SE, SMYRNA, GA 30082-3951
(404) 397-3009
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
164012155
IL
133N00000X
Nutritionist
Primary
DX5094
MD
133N00000X
Nutritionist
ND14157
FL
Other
Enumeration date
09/28/2020
Last updated
06/15/2025
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