Individual
SERWA CARRIE - LAKE SAMPLE - ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(518) 528-8977
Mailing address
3801 CONSHOHOCKEN AVE APT 710, PHILADELPHIA, PA 19131-5544
(518) 528-8977
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN007797
PA
Other
Enumeration date
08/26/2024
Last updated
08/27/2024
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