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Individual
JODY LEE K DIXON
Active
Individual
JODY LEE K DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
DN000432
PA
133V00000X
Registered Dietitian
Primary
DN000432
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102287927
—
PA
01
—
DN000432
LICENSE
PA
Enumeration date
06/12/2006
Last updated
10/16/2020
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