Individual
MISS SUELITA REYES DE LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD.LD.MS. CNS
Contact information
Practice address
1012 MARLEIGH CIR, TOWSON, MD 21204-2205
(410) 605-7629
(410) 605-7691
Mailing address
1012 MARLEIGH CIR, TOWSON, MD 21204-2205
(410) 605-7629
(410) 605-7691
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
R369988
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R369988
REGISTERED DIETITIAN
MD
Enumeration date
10/03/2006
Last updated
07/08/2007
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