Individual
MS. DEBRA WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
109 ASH LN, MOUNTAIN TOP, PA 18707-1522
(570) 824-3521
Mailing address
109 ASH LN, MOUNTAIN TOP, PA 18707-1522
(570) 824-3521
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
722184
PA
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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