Individual
ELLEN MARIE MICHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3301 EXECUTIVE DR, RALEIGH, NC 27609-7432
(919) 954-3174
Mailing address
3301 EXECUTIVE DR, RALEIGH, NC 27609-7432
(919) 954-3174
(919) 954-3177
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001531
NC
Other
Enumeration date
04/30/2014
Last updated
07/23/2024
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