Individual
KATIE WARREN HARTZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
116 DELLA MAR DR, HEADLAND, AL 36345-8464
(334) 726-7179
Mailing address
116 DELLA MAR DR, HEADLAND, AL 36345-8464
(334) 726-7179
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
944568
AL
133V00000X
Registered Dietitian
944568
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AUBURN UNIVERSITY
CDR
CO
01
—
CO STATE UNIVERSITY
RD
CO
Enumeration date
02/08/2007
Last updated
08/17/2007
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