Individual
MRS. MARY-JEANNE DER AVEDISSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
626 MYRTLE ST, GLENDALE, CA 91203-1612
(818) 240-4328
Mailing address
626 MYRTLE ST, GLENDALE, CA 91203-1612
(818) 240-4328
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
590756
CA
Other
Enumeration date
04/19/2007
Last updated
06/18/2013
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