Provider Demographics
NPI:1043675259
Name:ROBERTS, SALLIE GEER (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SALLIE
Middle Name:GEER
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MRS
Other - First Name:SALLIE
Other - Middle Name:WHITEFOORD
Other - Last Name:GEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13625 FIRENZA CIR
Mailing Address - Street 2:APARTMENT 104
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4405
Mailing Address - Country:US
Mailing Address - Phone:864-276-2171
Mailing Address - Fax:
Practice Address - Street 1:7810 BALLANTYNE COMMONS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3415
Practice Address - Country:US
Practice Address - Phone:704-995-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004796133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered