Individual
MS. JENNIFER SOUCIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., LDN
Contact information
Practice address
1600 E JACKSON ST, MACOMB, IL 61455-2530
(309) 837-9917
Mailing address
1600 E JACKSON ST, MACOMB, IL 61455-2530
(309) 837-9917
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164000202
IL
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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