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General NPI Number Information
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NPI Number | 1023260494
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Entity Type | Individual
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Provider Name | JULIE M SHEREDA
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Gender | Female
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 5758 COOLEY LAKE RD
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City | WATERFORD
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State | MI
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Zip | 48327-3073
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Country | US
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Telephone | 855-466-3631
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Fax | 810-244-0226
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Provider Business Mailing Address
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Address Line | 27301 DEQUINDRE RD 306
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-3473
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Country | US
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Telephone | 248-546-1171
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Fax | 248-546-1288
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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