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Individual

SUSAN TYLER WALLACE HARDING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., R.D., L.D.N.

Contact information

Practice address
2909 MANOR RD, CHARLOTTE, NC 28209-2247
(804) 337-8835
Mailing address
2909 MANOR RD, CHARLOTTE, NC 28209-2247
(804) 337-8835

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
L004973
NC
133V00000X
Registered Dietitian
Primary
L004973
NC

Other

Enumeration date
08/30/2016
Last updated
08/30/2016
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