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MRS. AMANDA HENDERSON HUBBARD RD

>> Dietitian, Registered >> Dietary & Nutritional Service Providers

Registrant NPI Number: 1285036962

Individual Registrant:
MRS. AMANDA HENDERSON HUBBARD RD
Gender: F
Sole Proprietor

Location and contact information for practice:
611 CLIMBING ROSE BLVD APT L GRANITEVILLE, SC 29829-4110 US
Tel: 803-374-7023  Fax: --

Contact information for business:
611 CLIMBING ROSE BLVD APT L GRANITEVILLE, SC 29829-4110 US
Tel: 803-374-7023  Fax: --

Registration Information:
NPI: 1285036962
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y133V00000XDietary & Nutritional Service Providers
Dietitian, Registered
GALD003929

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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