Individual
TABETHA FOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD/N
Contact information
Practice address
13295 SMITHWICK LN, JACKSONVILLE, FL 32226-0717
(904) 718-2774
Mailing address
13295 SMITHWICK LN, JACKSONVILLE, FL 32226-0717
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND7222
FL
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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