Individual
MRS. TALITHA ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RD, LDN
Contact information
Practice address
103 ILLICIUM CT, CARY, NC 27518-9166
(919) 602-7062
Mailing address
103 ILLICIUM CT, CARY, NC 27518-9166
(919) 602-7062
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00953812
CA
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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