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Individual

JODI BLOOM HADAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, LD

Contact information

Practice address
740 S LIMESTONE STE D201, LEXINGTON, KY 40536-0001
(859) 323-0079
(859) 323-8173
Mailing address
301 CLAYTON AVE, GEORGETOWN, KY 40324-1516
(859) 693-6077

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
123820
KY

Other

Enumeration date
05/24/2022
Last updated
07/07/2022
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