Individual
MISS CASANDRA RENEE STIDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CSR, CCTD
Contact information
Practice address
2110 E NORRIS ST UNIT 301, PHILADELPHIA, PA 19125-1946
(812) 896-6236
Mailing address
2110 E NORRIS ST UNIT 301, PHILADELPHIA, PA 19125-1946
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
133VN1005X
Renal Nutrition Registered Dietitian
Primary
86025925
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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