Individual
MS. MARIE LATENDRESSE WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D., C.D.E.
Contact information
Practice address
711 ROANOKE AVE, ELIZABETH CITY, NC 27909-5643
(252) 338-4370
(252) 337-7911
Mailing address
801 W COLONIAL AVE, ELIZABETH CITY, NC 27909-4221
(252) 338-4370
(252) 337-7911
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
00515071
TN
133V00000X
Registered Dietitian
1554
TN
133V00000X
Registered Dietitian
Primary
L002954
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0932-6070
CERTIFIED DIABETES EDUCAT
NC
01
—
1554
LICENSED DIETITIAN
TN
01
—
515071
AMERICAN DIETETIC ASSOC.
TN
01
—
L002954
LICENSED DIETITIAN
NC
Enumeration date
10/27/2006
Last updated
07/08/2007
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