Individual
STACIE D AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN LD
Contact information
Practice address
1875 FORTUNE RD, C/O WIC NUTRITION SERVICE DEPARTMENT, KISSIMMEE, FL 34744-4428
(140) 734-3200
Mailing address
1875 FORTUNE ROAD, C/O WIC NUTRITION SERVICE DEPARTMENT, KISSIMMEE, FL 34744
(140) 734-3200
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND7146
FL
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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