Individual
TARA JEAN LEVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(215) 952-9248
Mailing address
2021 WALNUT ST APT 6, PHILADELPHIA, PA 19103-4553
(267) 246-5964
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86007432
PA
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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