Individual
MALLORY BLAINE DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, RDN, LDN, CHES
Contact information
Practice address
420 N 20TH ST, PHILADELPHIA, PA 19130-3828
(215) 496-2662
Mailing address
250 S MAPLE ST UNIT 2411, AMBLER, PA 19002-5540
(908) 872-2070
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN007571
PA
Other
Enumeration date
05/10/2023
Last updated
05/15/2023
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