Individual
MRS. DIANA M FEDORISIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
1677 HEMLOCK FARMS, LORDS VALLEY, PA 18428-9069
(570) 257-0136
Mailing address
1677 HEMLOCK FARMS, LORDS VALLEY, PA 18428-9069
(570) 257-0136
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004617
PA
Other
Enumeration date
01/27/2013
Last updated
01/27/2013
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