NPI 1073871232 · live from the CMS NPI Registry
Tyra Chay Bradbury, RD
Dietitian, Registered, Nutrition, Pediatric in Charleston, SC. National Provider Identifier 1073871232, active.
NPI record
| NPI | 1073871232 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered, Nutrition, Pediatric 133VN1004X |
| Practice location | 165 Ashley Ave, Msc 905, Charleston, SC 29425 |
| Practice phone | 843-792-3880 |
| Enumerated | April 25, 2012 |
| Last updated | April 25, 2012 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Pediatric primary | 133VN1004X | 1014 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.