Individual
IVORY LIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
15195 HEATHCOTE BLVD STE 330, HAYMARKET, VA 20169
(571) 284-3380
(571) 284-3389
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
101206
AK
133V00000X
Registered Dietitian
Primary
86049472
VA
Other
Enumeration date
08/13/2015
Last updated
07/28/2021
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