Individual
MS. DIANE ELAINE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RD,CDE
Contact information
Practice address
2157 APPERSON DR, SALEM, VA 24153-7235
(540) 777-0000
Mailing address
10102 EDGECOMBE PL NE, BAINBRIDGE ISLAND, WA 98110-4334
(412) 400-3204
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
572543
PA
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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