Provider Demographics
NPI:1558931576
Name:GANIO MOLINARI, MEGHAN SUE (RD)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:SUE
Last Name:GANIO MOLINARI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-6119
Mailing Address - Country:US
Mailing Address - Phone:786-512-4627
Mailing Address - Fax:
Practice Address - Street 1:1221 CLOVER LN
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-6119
Practice Address - Country:US
Practice Address - Phone:786-512-4627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006429133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered