Individual
LEIGH BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1222 MORRIS ST, TURBEVILLE, SC 29162-8959
(843) 412-4907
Mailing address
1222 MORRIS ST, TURBEVILLE, SC 29162-8959
(184) 341-2490
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
804
SC
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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