Healthcare Provider Details

I. General information

NPI: 1922423029
Provider Name (Legal Business Name): VALERIE CALHOUN MS, RD, LDN.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 02/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8332 TANYA DR
GREENWOOD LA
71033-3339
US

IV. Provider business mailing address

8332 TANYA DR
GREENWOOD LA
71033-3339
US

V. Phone/Fax

Practice location:
  • Phone: 318-773-6220
  • Fax: 318-681-5559
Mailing address:
  • Phone: 318-773-6220
  • Fax: 318-681-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number583
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: