Individual
MARISHA LEAIRA BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
7004 SMITH CORNERS BLVD STE A, CHARLOTTE, NC 28269-3827
(704) 688-9650
Mailing address
7004 SMITH CORNERS BLVD STE A, CHARLOTTE, NC 28269-3827
(704) 688-9650
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005925
NC
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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