Individual
MS. STEPHANIE DYAN TARVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDN,RD
Contact information
Practice address
1035 CRESWELL AVE, SHREVEPORT, LA 71101-3917
(318) 676-5159
Mailing address
1525 FAIRFIELD AVE, RM. 569, SHREVEPORT, LA 71101-4300
(318) 676-7473
(318) 676-7560
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
1313
LA
133V00000X
Registered Dietitian
Primary
832710
LA
Other
Enumeration date
07/27/2012
Last updated
07/27/2012
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