Individual
MARYANN CODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CDE
Contact information
Practice address
3 COOPER PLZ, SUITE 309, CAMDEN, NJ 08103-1438
(856) 342-3059
(856) 541-6213
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 963-6888
(856) 968-8499
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
654063
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09610094
CERTIFICATION NUMBER
NJ
Enumeration date
07/28/2010
Last updated
07/28/2010
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