Individual
HEATHER RUDALAVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
1023 HAWTHORNE LN, FORT WASHINGTON, PA 19034-1736
(215) 643-3572
Mailing address
1023 HAWTHORNE LN, FORT WASHINGTON, PA 19034-1736
(215) 696-3238
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004094
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265734917
NPI
PA
Enumeration date
12/01/2010
Last updated
02/01/2019
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