| Doctor Name: | MRS. TIA NICOLE WADE |
| NPI Number: | 1467710376 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MBA, RD, LDN |
| License Number: | DN004659 |
| Business Practice Address: | 8901 Route 30 North Huntingdon, PA - 156422704 |
| Business Phone Number: | 7248640100 |
| Business Fax Number: | |
| Mailing Address: | 8901 Route 30, NORTH HUNTINGDON |
| State: | PA |
| Postal Code: | 156422704 |
| Phone Number: | 7248640100 |
| Fax Number: | |
| NPI Enumeration Date: | 04/27/2012 |
| NPI Last Update Date: | 04/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | DN004659 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |