Individual
KELLYANN STANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
406 TREE ST, PHILADELPHIA, PA 19148-5707
(484) 274-0741
Mailing address
406 TREE ST, PHILADELPHIA, PA 19148-5707
(484) 274-0741
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006951
PA
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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