Individual
MRS. TERRIE DENISE WEAVER FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD LD
Contact information
Practice address
16354 ROSEROCK CIR, CHOCTAW, OK 73020-6964
(405) 390-1593
Mailing address
16354 ROSEROCK CIR, CHOCTAW, OK 73020-6964
(405) 390-1593
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD1901
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1901
LICENSED DIETITIAN
OK
01
—
708464
REGISTERED DIETITIAN
—
Enumeration date
02/21/2013
Last updated
03/24/2015
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