Individual
ANDREA SPIVACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RD, LDN
Contact information
Practice address
3535 MARKET ST, MEZZANINE/STUNAKRD PROGRAM, PHILA, PA 19444
(215) 746-4112
Mailing address
3535 MARKET ST, MEZZANINE LEVEL/STUNKARD PRGRAM, PHILA, PA 19104
(215) 746-4112
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN003746
PA
Other
Enumeration date
05/06/2016
Last updated
05/23/2016
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