Individual
MRS. JENNIFER WYNNE BOPP DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
4904 S POWER RD, MESA, AZ 85212-3609
(602) 770-7611
Mailing address
3420 S MERCY RD, GILBERT, AZ 85297-0419
(602) 770-7611
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
968353
AZ
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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