Individual
AMANDA STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 MADISON AVE, MOUNT HOLLY, NJ 08060-2038
(732) 814-9179
Mailing address
900 ROUTE 168 STE A2, TURNERSVILLE, NJ 08012-3207
(215) 764-9651
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86027624
CDR
—
Enumeration date
06/18/2019
Last updated
05/20/2020
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