| Organization Name: | CHRYSALIS CENTER FOR COUNSELING AND EATING DISORDER TREATMENT PLLC |
| NPI Number: | 1073818704 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY BROADWATER PICKELL (CO-OWNER/PSYCHOLOGIST) |
| Mailing Address: | 3904 Oleander Dr Suite 101 Wilmington |
| State: | NC US |
| Postal Code: | 284036717 |
| Phone Number: | 9107909500 |
| Fax Number: | 9107968111 |
| NPI Enumeration Date: | 01/11/2011 |
| NPI Last Update Date: | 07/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | L002681 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |