Individual
LISA S KNOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-5283
(717) 782-5192
Mailing address
409 S 2ND ST, 2F, HARRISBURG, PA 17104-1612
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
DN000007
PA
133V00000X
Registered Dietitian
Primary
DN000007
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103125389
—
PA
Enumeration date
05/11/2016
Last updated
09/17/2018
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