Provider Demographics
NPI:1871261628
Name:WILLIAMS MORAIS, MEGAN ANGELA MARIE (RDN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANGELA MARIE
Last Name:WILLIAMS MORAIS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 STONEWALL CT APT 3104
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7985
Mailing Address - Country:US
Mailing Address - Phone:909-705-6750
Mailing Address - Fax:
Practice Address - Street 1:350 STONEWALL CT APT 3104
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7985
Practice Address - Country:US
Practice Address - Phone:843-732-6450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-04
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86131445133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered