Doctor Name: | MRS. JENNIFER WYNNE BOPP DALE |
NPI Number: | 1497177992 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., R.D. |
License Number: | 968353 |
Business Practice Address: | 4904 S Power Rd Mesa, AZ - 852123609 |
Business Phone Number: | 6027707611 |
Business Fax Number: | |
Mailing Address: | 3420 S Mercy Rd, GILBERT |
State: | AZ |
Postal Code: | 852970419 |
Phone Number: | 6027707611 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2014 |
NPI Last Update Date: | 01/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 968353 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |