Individual
MRS. ALYSSA JENNIFER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN
Contact information
Practice address
160 E MAIN ST, PORT JERVIS, NY 12771-2253
(845) 858-7023
Mailing address
160 E MAIN ST, PORT JERVIS, NY 12771-2253
(845) 858-7023
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
889231
NY
Other
Enumeration date
03/06/2010
Last updated
03/06/2010
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