Individual
MRS. TEISHA LIGHTBOURNE DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RD, CNSC, IBCLC
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-4278
Mailing address
200 TRENT DRIVE PURPLE ZONE ROOM 015 BASEMENT, DURHAM, NC 27710-0001
(919) 668-6136
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005095
NC
Other
Enumeration date
05/27/2015
Last updated
03/14/2023
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