Individual
LINDSEY A KAVALOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DIETICIAN
Contact information
Practice address
1000 E MOUNTAIN BLVD, WILKES BARRE, PA 18711-0027
(570) 808-7803
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004907
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN004907
LICENSE
PA
Enumeration date
06/17/2013
Last updated
10/20/2017
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