Individual
MS. JENNIFER LYNN DORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
167 BELMAR BOULEVARD, AVON LAKE, OH 44012
(440) 933-0242
Mailing address
167 BELMAR BLVD, AVON LAKE, OH 44012-1337
(440) 933-0242
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
5661
OH
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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