Provider Demographics
NPI:1982935722
Name:SHELHAMER, JULIE DIAZ (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:DIAZ
Last Name:SHELHAMER
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SPRING HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-4018
Mailing Address - Country:US
Mailing Address - Phone:540-459-5728
Mailing Address - Fax:
Practice Address - Street 1:1000 N SHENANDOAH AVE
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3547
Practice Address - Country:US
Practice Address - Phone:540-636-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA863719133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered