Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 2501 | NC |
NPI | 1598080103 |
---|---|
Provider Name | Dr. Susan D Osada |
First Address | Concord, NC 28025-5018 |
Second Address | Asheville, NC 28801-3794 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 21/10/2019 |