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Individual

MRS. DOMINIQUE SHOWMAKER JOHNSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD LDN

Contact information

Practice address
55 MEADOWFIELD DR, SOUTHAMPTON, PA 18966-3043
(215) 200-1047
Mailing address
55 MEADOWFIELD DR, SOUTHAMPTON, PA 18966-3043
(215) 200-1047

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006364
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86084794
COMMISSION ON DIETETIC REGISTRATION CDR
Enumeration date
03/06/2023
Last updated
03/06/2023
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