Individual
OLIVIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4800 48TH ST, VALLEY, AL 36854-3666
(334) 710-0037
Mailing address
4800 48TH ST, VALLEY, AL 36854-3666
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
Other
Enumeration date
10/12/2020
Last updated
11/02/2020
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