Individual
MRS. JESSICA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
506 MILANO DR, EASTON, PA 18040-7923
(864) 320-1767
Mailing address
506 MILANO DR, EASTON, PA 18040-7923
(864) 320-1767
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006979
PA
Other
Enumeration date
09/20/2010
Last updated
08/01/2021
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