Individual
JENNIFER L IVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDN
Contact information
Practice address
211 CHURCH ST, SARATOGA SPRINGS, NY 12866-1003
(518) 583-8646
Mailing address
211 CHURCH STREET, SARATOGA SPRINGS, NY 12866
(518) 583-8646
(518) 583-8367
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
007128
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007128
NYSED
NY
Enumeration date
03/02/2011
Last updated
04/25/2013
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