Healthcare Provider Details

I. General information

NPI: 1912541962
Provider Name (Legal Business Name): MARLEE JUNE SCHRIFT MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2019
Last Update Date: 11/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 HOWARD AVE
ALTOONA PA
16601-4804
US

IV. Provider business mailing address

435 WHISKEY SPRINGS RD
SUMMERHILL PA
15958-4905
US

V. Phone/Fax

Practice location:
  • Phone: 814-889-2011
  • Fax:
Mailing address:
  • Phone: 814-659-3808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86083858
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: