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Individual

THERESA STAHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LDN

Contact information

Practice address
12501 WILLOWBROOK RD, WOC 2ND FLOOR, CUMBERLAND, MD 21502-2569
(240) 964-8416
(240) 964-8601
Mailing address
13005 LEWIS HEIGHTS DR SW, LAVALE, MD 21502-6512
(240) 727-8626
(877) 284-3984

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
N00111
MD
133V00000X
Registered Dietitian
Primary
N00111
MD
133VN1004X
Pediatric Nutrition Registered Dietitian
N00111
MD
133VN1005X
Renal Nutrition Registered Dietitian
N00111
MD
133VN1006X
Metabolic Nutrition Registered Dietitian
N00111
MD
282N00000X
General Acute Care Hospital
N00111
MD

Other

Enumeration date
01/03/2012
Last updated
02/17/2014
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