Individual
NICOLE DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LDN,CNSC
Contact information
Practice address
8151 RIDGE AVE, PHILADELPHIA, PA 19128-2902
(215) 487-2500
Mailing address
8151 RIDGE AVE, PHILADELPHIA, PA 19128-2902
(215) 487-2500
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
867433
PA
133V00000X
Registered Dietitian
Primary
DN002287
PA
Other
Enumeration date
11/03/2010
Last updated
07/31/2011
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