Individual
ELAINA HARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 353-6124
(229) 353-7722
Mailing address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 353-6124
(229) 353-7722
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD003116
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD003116
934145
GA
Enumeration date
03/11/2013
Last updated
03/11/2013
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