Individual
DIANE M HENDERIKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
4 HARTFORD DR, TINTON FALLS, NJ 07701-4929
(732) 922-6269
(732) 918-8757
Mailing address
PO BOX 486, OAKHURST, NJ 07755-0486
(732) 922-6269
(732) 918-8757
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
857625
NJ
Other
Enumeration date
01/17/2006
Last updated
07/08/2007
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