Individual
MONIQUE IDELETTE-LOUW STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1131 SALUDA ST, ROCK HILL, SC 29730-5776
(803) 325-8742
Mailing address
431 EBENEZER AVE, ROCK HILL, SC 29730-3539
(864) 423-9937
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2510
SC
133V00000X
Registered Dietitian
L007003
NC
Other
Enumeration date
09/15/2022
Last updated
05/22/2024
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