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Individual

MARY JO HANEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, CSP

Contact information

Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7464
(757) 668-9108
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7464
(757) 668-9108

Taxonomy

Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary

Other

Enumeration date
04/05/2017
Last updated
04/05/2017
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