Individual
MRS. STACEY WOODSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
3412 TYSON RD, NEWTOWN SQUARE, PA 19073-3420
(610) 359-1700
Mailing address
1424 KENILWORTH ST, PHILADELPHIA, PA 19146-2208
(267) 239-5637
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN003988
PA
Other
Enumeration date
03/26/2010
Last updated
07/10/2018
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