Doctor Name: | EMILY EDWARDS |
NPI Number: | 1558763458 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS,RD,LD |
License Number: | 164006321 |
Business Practice Address: | 2023 Vadalabene Dr Suite 200 Maryville, IL - 620625630 |
Business Phone Number: | 6182887408 |
Business Fax Number: | 6182887418 |
Mailing Address: | 2023 Vadalabene Dr, Suite 200 MARYVILLE |
State: | IL |
Postal Code: | 620625630 |
Phone Number: | 6182887408 |
Fax Number: | 6182887418 |
NPI Enumeration Date: | 09/23/2014 |
NPI Last Update Date: | 09/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 164006321 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |