Individual
JENNA ELIZABETH FADALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
952 BETHANY TPKE, HONESDALE, PA 18431-4194
(716) 949-0006
Mailing address
952 BETHANY TPKE, HONESDALE, PA 18431-4194
(716) 949-0006
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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