Individual
MRS. ANDREA MICHELLE PENIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D., L.D.
Contact information
Practice address
12662 TELECOM DR, TEMPLE TERRACE, FL 33637-0935
(706) 614-9119
Mailing address
12662 TELECOM DR, TEMPLE TERRACE, FL 33637-0935
(706) 614-9119
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
11855
FL
133V00000X
Registered Dietitian
LD003506
GA
Other
Enumeration date
04/13/2010
Last updated
02/09/2023
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