Individual
JULIANNA FAULKNER REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1015 BOWLES AVE, FENTON, MO 63026-2394
(636) 496-3330
(636) 496-4985
Mailing address
1015 BOWLES AVE, FENTON, MO 63026-2394
(636) 496-3330
(636) 496-4985
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
200126153
MO
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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