Provider Demographics
NPI:1447496070
Name:CHRISTIE, MIRIAM HELENA (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:HELENA
Last Name:CHRISTIE
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 1:9 SQUIRES MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5111
Mailing Address - Country:US
Mailing Address - Phone:925-639-6179
Mailing Address - Fax:
Practice Address - Street 1:9 SQUIRES MEADOW CT
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5111
Practice Address - Country:US
Practice Address - Phone:925-639-6179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-03
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA874869133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered