Individual
MS. MARY ANN VINCENTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1909
(570) 326-8410
Mailing address
RR#1, BOX 1254A, FORKSVILLE, PA 18616-9722
(570) 924-3297
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN000304
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN000304
LDN LICENSE
PA
Enumeration date
12/11/2006
Last updated
07/08/2007
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