Organization
HEALTH WELLNESS PACK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAPHENE ALTEMA-JOHNSON RDN,MBA,MPH (DIETITIAN)
(443) 285-1454
Entity
Organization
Contact information
Practice address
6127 JERRYS DR, COLUMBIA, MD 21044-3824
(443) 285-1454
Mailing address
6127 JERRYS DR, COLUMBIA, MD 21044-3824
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DX5601
RDN LICENSE
MD
Enumeration date
11/28/2022
Last updated
11/28/2022
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