Individual
MARY MARGARET WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
905 VERDAE BLVD STE 103, GREENVILLE, SC 29607-4029
(864) 522-2186
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6308
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1746
SC
Other
Enumeration date
05/07/2018
Last updated
05/08/2019
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