Individual
MS. DIANNE LEBLANC WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 789-6471
(843) 805-5957
Mailing address
934 ETIWAN PARK ST, DANIEL ISLAND, SC 29492-7922
(843) 388-2294
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
657827
ADA REGISTRATION NUMBER
—
Enumeration date
09/20/2006
Last updated
07/08/2007
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