Individual
TABITHA RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, RD, LD/N
Contact information
Practice address
18 LAKE VISTA WAY, ORMOND BEACH, FL 32174-6785
(386) 673-2915
Mailing address
18 LAKE VISTA WAY, ORMOND BEACH, FL 32174-6785
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND5535
FL
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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