Individual
MRS. JENNIFER CAUDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2271 HAVERFORD DR, BELLEVILLE, IL 62221-7994
(618) 310-3639
Mailing address
2271 HAVERFORD DR, BELLEVILLE, IL 62221-7994
(618) 310-3639
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005094
IL
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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