Individual
HEATHER ELIZABETH BANKS-BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RD, LDN
Contact information
Practice address
709 NORTHEAST DR STE 20, DAVIDSON, NC 28036-7425
(704) 896-7776
Mailing address
526 OLMSTED PARK PL, CHARLOTTE, NC 28203-5681
(704) 910-4309
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001121
NC
133V00000X
Registered Dietitian
L001121
—
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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