Individual
AISHA FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
612 COLLEGE ST, JACKSONVILLE, NC 28540-5311
(910) 989-3971
Mailing address
612 COLLEGE ST, JACKSONVILLE, NC 28540-5311
(910) 989-3971
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L004574
NC
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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