Individual
CARLA J WIEDERHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LDN,CNSD
Contact information
Practice address
500 UPPER CHESAPEAKE DR, FOOD AND NUTRITION DEPARTMENT, BEL AIR, MD 21014-4324
(443) 643-2736
(443) 643-2170
Mailing address
500 UPPER CHESAPEAKE DR, FOOD AND NUTRITION DEPARTMENT, BEL AIR, MD 21014-4324
(443) 643-2736
(443) 643-2170
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D01851
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105114
JHU
MD
Enumeration date
02/07/2007
Last updated
07/08/2007
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