Individual
MRS. LISA D JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
24 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1476
(304) 720-2222
(304) 720-2322
Mailing address
24 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1476
(304) 720-2222
(304) 720-2322
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
464
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
464
LICENSED DIETITIAN
WV
01
—
873638
COMMISSION ON DIETETIC RE
WV
Enumeration date
09/20/2005
Last updated
02/01/2022
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