Organization
JACINTA NUTRITION AND DIABETES EDUCATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHERINE C GENTHNER MAS, RDN, LDN, CDE (QUALITY COORDINATOR)
(443) 652-3674
Entity
Organization
Contact information
Practice address
21 WEST RD STE 103, BALTIMORE, MD 21204-2307
(443) 652-3674
(443) 895-4165
Mailing address
21 WEST RD STE 103, BALTIMORE, MD 21204-2307
(443) 652-3674
(443) 895-4165
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D01213
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13909823
CAQH PROVIEW
—
01
—
DC74-0000
CAREFIRST BLUE CROSS BLUE SHIELD
MD
Enumeration date
02/08/2018
Last updated
02/08/2018
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