Individual
ANDREA ROSE DUDENHOEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5917 MYSTIC RDG, ERIE, PA 16506-7042
(814) 403-0753
Mailing address
5917 MYSTIC RDG, ERIE, PA 16506-7042
(814) 403-0753
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86108941
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86108941
—
PA
Enumeration date
07/31/2019
Last updated
07/31/2019
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