Individual
JULIA NICOLE DECECCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
608 MONTGOMERY RD, AMBLER, PA 19002-3531
(267) 566-9735
Mailing address
608 MONTGOMERY RD, AMBLER, PA 19002-3531
(267) 566-9735
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86110900
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86110900
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
10/02/2020
Last updated
10/02/2020
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