Individual
MS. JOANN MARIE BANIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
14 WOODLAND AVE, WELLSBORO, PA 16901-1907
(570) 724-5998
Mailing address
14 WOODLAND AVE, WELLSBORO, PA 16901-1907
(570) 724-5998
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN000873
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101530971
PROMISE
PA
Enumeration date
05/13/2008
Last updated
05/13/2008
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