Individual
JESSICA LYNN BERENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
6633 FAIRVIEW RD, CHARLOTTE, NC 28210-3321
(704) 366-1264
Mailing address
6633 FAIRVIEW RD, CHARLOTTE, NC 28210-3321
(704) 366-1264
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005057
NC
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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