Individual
MS. TINA SCHMIDT DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
9414 PENSHURST TRCE, CHARLOTTE, NC 28210-7713
(704) 747-9457
(980) 236-7656
Mailing address
9414 PENSHURST TRCE, CHARLOTTE, NC 28210-7713
(704) 747-9457
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
833664
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833664
REGISTERED DIETIAN
NC
01
—
L001240
LICENSED DIETITIAN
NC
Enumeration date
09/07/2012
Last updated
09/07/2012
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