Individual
JACQUELYN BEDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
MG886A.4 DTHC CORRIDOR # 8, 5801 ARMY PENTAGON, WASHINGTON, DC 20310-5801
(703) 692-8891
Mailing address
3501 CHESTERBROOK CT, APT 618, RICHMOND, VA 23233-1296
(804) 387-3200
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DX2605
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
931718
CDR
—
01
—
DX2605
LDN
MD
Enumeration date
06/21/2006
Last updated
07/08/2007
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