Individual
MRS. JENNA MARIE VANDIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
520 WOODHILL CT, GRAPEVINE, TX 76051-4400
(616) 830-8190
Mailing address
520 WOODHILL CT, GRAPEVINE, TX 76051-4400
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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