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Individual

MS. JESSICA MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDN, LDN

Contact information

Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
Mailing address
311 NORTH ST, WEST PITTSTON, PA 18643-2127
(570) 466-8319

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006948
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-
-
Enumeration date
11/30/2019
Last updated
11/30/2019
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