Individual
JESSICA ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1136 W 17TH ST, STE. B, BLOOMINGTON, IN 47404-3002
(260) 227-1174
Mailing address
3213 S WALNUT SPRINGS DR, BLOOMINGTON, IN 47401-7424
(260) 227-1174
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86052599
IN
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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