Individual
MRS. CAROLYN A BLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
136 EAST AVE, ERIE, PA 16507-1842
(814) 453-7661
(814) 455-1132
Mailing address
136 EAST AVE, ERIE, PA 16507-1842
(814) 453-7661
(814) 455-1132
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
874207
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101104657 0001
—
PA
01
—
BL1839431
HIGHMARK
—
Enumeration date
04/16/2007
Last updated
03/17/2008
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