Individual
GENEVIEVE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LDN, CDCES
Contact information
Practice address
7202 RAINBOW LN, FREDERICK, MD 21702-2979
(781) 223-0746
Mailing address
7202 RAINBOW LN, FREDERICK, MD 21702-2979
(781) 223-0746
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1044258
COMMISSION ON DIETETIC REGISTRATION
—
01
—
DI100000694
DISTRICT OF COLUMBIA BOARD OF DIETETICS AND NUTRITION
DC
01
—
DX3311
MARYLAND STATE BOARD OF DIETETIC PRACTICE
—
Enumeration date
03/04/2013
Last updated
05/15/2024
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