Doctor Name: | MS. MARY NELL SOUTHARD |
NPI Number: | 1144343849 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D.,L.D. |
License Number: | 119 |
Business Practice Address: | 1 Choctaw Way Nutrition Services Talihina, OK - 745712022 |
Business Phone Number: | 9185677000 |
Business Fax Number: | |
Mailing Address: | Hc 69 Box 245, SNOW |
State: | OK |
Postal Code: | 745679717 |
Phone Number: | 9187554364 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 119 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
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 |