Individual
MRS. JESSICA RAE BODZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RDN,LDN
Contact information
Practice address
189 BOB BLACK RD, LAKE ARIEL, PA 18436-4508
(570) 840-2264
Mailing address
189 BOB BLACK RD, LAKE ARIEL, PA 18436-4508
(570) 840-2264
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN003249
PA
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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