Individual
MS. MARY BICKEL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED DIETITIAN/
Contact information
Practice address
33 FULTON PLAZA, MIDDLETOWN, NY 10940
(845) 346-1300
(845) 346-1298
Mailing address
33 FULTON PLAZA, MIDDLETOWN, NY 10940
(845) 346-1300
(845) 346-1298
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
004474-1
NY
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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