Individual
CALLI WATFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1175 COOK RD STE 145, ORANGEBURG, SC 29118-8235
(803) 395-3891
(803) 536-5220
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 395-2237
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1770
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770
LICENSE
SC
Enumeration date
01/07/2021
Last updated
01/07/2021
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