Individual
JESSICA BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD
Contact information
Practice address
10105 N BRIDGEWATER CIR, OWASSO, OK 74055-7727
(918) 272-4207
(866) 296-1005
Mailing address
1617 S COLUMBIA PL, TULSA, OK 74104-5905
(802) 299-0138
(866) 296-1005
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2119
OK
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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