Individual
MARYAM NIKANTABAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 BROOKHILL SQ S # PA, SUGARLOAF, PA 18249-1010
(570) 459-0029
Mailing address
435 BEECH AVE, HERSHEY, PA 17033-1610
(717) 808-1667
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
DN006783
PA
Other
Enumeration date
01/02/2020
Last updated
01/24/2020
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