Individual
EMILY CLYDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
114 STATE ST, LAKE CHARLES, LA 70605-5718
(337) 419-0942
Mailing address
114 STATE ST, LAKE CHARLES, LA 70605-5718
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3173
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3173
LBEDN
LA
Enumeration date
07/14/2022
Last updated
07/14/2022
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