Individual
MS. JOLEEN MARIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD LDN CDE
Contact information
Practice address
125 E 34TH ST, ERIE, PA 16504-1509
(814) 335-4147
Mailing address
125 E 34TH ST, ERIE, PA 16504-1509
(814) 335-4147
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN003333
PA
Other
Enumeration date
10/11/2005
Last updated
01/12/2011
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