Individual
JACQUELINE PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
12235 VANCE JACKSON RD APT 932, SAN ANTONIO, TX 78230-5965
(319) 899-7746
Mailing address
12235 VANCE JACKSON RD APT 932, SAN ANTONIO, TX 78230-5965
(319) 899-7746
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT85216
TX
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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