Provider Demographics
NPI:1295777878
Name:EMORY, MONICA (MS,RD, LD/N)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:EMORY
Suffix:
Gender:F
Credentials:MS,RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 11TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-1925
Mailing Address - Country:US
Mailing Address - Phone:727-643-2319
Mailing Address - Fax:
Practice Address - Street 1:319 11TH AVE NE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-1925
Practice Address - Country:US
Practice Address - Phone:727-643-2319
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4924133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered