Individual
NICOLE WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RD, LDN
Contact information
Practice address
34 LLANDILLO RD, HAVERTOWN, PA 19083-4708
(610) 220-2014
Mailing address
34 LLANDILLO RD, HAVERTOWN, PA 19083-4708
(610) 220-2014
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN003898
PA
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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