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Organization

YOUR WELLNESS CONSULTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DANIELLE DIMARCO MS, RD, LDN, CPT (PARTNER/REGISTERED DIETITIAN)
(610) 331-5439
Entity
Organization

Contact information

Practice address
2835 TYSON AVE, PHILADELPHIA, PA 19149-1415
(610) 331-5439
Mailing address
1 PRESIDENTIAL BLVD STE 203, BALA CYNWYD, PA 19004-1007
(610) 331-5439

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004701
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1508142696
NPI
PA
01
1609167543
NPI
PA
Enumeration date
11/05/2014
Last updated
11/05/2014
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