Individual
KAITLIN DETTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
283 SECOND STREET PIKE STE 145, SOUTHAMPTON, PA 18966-3869
(215) 322-2213
Mailing address
484 SILVER AVE, SOUTHAMPTON, PA 18966-3541
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN005331
PA
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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