Individual
MS. BROOKE M MERCEDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSSD
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
956619
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
540506332
—
VA
Enumeration date
02/17/2012
Last updated
01/17/2013
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