Individual
JILLIAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
300 MOUNT LEBANON BLVD STE 209C, PITTSBURGH, PA 15234-1507
(412) 720-3343
Mailing address
211 AVENUE A, SCHUYLKILL HAVEN, PA 17972-1302
(570) 225-1848
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006463
PA
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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