Individual
MS. STEPHANIE FLEETWOOD DEIVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
521 MT PLEASANT DR, SCRANTON, PA 18503-1993
(570) 342-8500
(570) 558-2290
Mailing address
100 N ACADEMY AVE, CREDENTIALS DEPT, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN003387
PA
Other
Enumeration date
05/30/2006
Last updated
12/24/2020
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