Individual
STEPHANIE ALEXIS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
905 VERDAE BLVD STE 202, GREENVILLE, SC 29607-4098
(864) 522-2100
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-2100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2155
SC
133V00000X
Registered Dietitian
Primary
86172573
WI
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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