Individual
SAMANTHA WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
565 GLENMORE AVE, ELKINS PARK, PA 19027-1704
(215) 872-2067
Mailing address
565 GLENMORE AVE, ELKINS PARK, PA 19027-1704
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86107039
—
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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