Healthcare Provider Details

I. General information

NPI: 1194791079
Provider Name (Legal Business Name): SHELLIE K YEUNG MS,RD,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 OAKLAWN DR
PITTSBURGH PA
15241-1772
US

IV. Provider business mailing address

389 OAKLAWN DR
PITTSBURGH PA
15241-1772
US

V. Phone/Fax

Practice location:
  • Phone: 412-835-0791
  • Fax:
Mailing address:
  • Phone: 412-835-0791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN003002
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: