Provider Demographics
NPI:1891103644
Name:WALSH-ALEEM, MEGAN LYNN (RD, LD/N, CDCES)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNN
Last Name:WALSH-ALEEM
Suffix:
Gender:F
Credentials:RD, LD/N, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20420 CAROLINA CHERRY CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2982
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20420 CAROLINA CHERRY CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2982
Practice Address - Country:US
Practice Address - Phone:603-801-4029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6958133V00000X
FLND 6958133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered