Individual
MS. JACQUELINE DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
211 S 9TH ST, SUITE 600, PHILA, PA 19107-6810
(215) 955-0453
Mailing address
1179 CLEVELAND RD, BLUE BELL, PA 19422-1807
(484) 919-7480
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DNOO1179
PA
Other
Enumeration date
08/27/2009
Last updated
09/18/2012
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