Healthcare Provider Details

I. General information

NPI: 1437628823
Provider Name (Legal Business Name): MELISSA WILSON TWEDT MS, CNS, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 MILES RD STE E
WEST CHESTER PA
19380-1929
US

IV. Provider business mailing address

780 MILES RD STE E
WEST CHESTER PA
19380-1929
US

V. Phone/Fax

Practice location:
  • Phone: 610-696-1860
  • Fax: 484-947-5606
Mailing address:
  • Phone: 610-696-1860
  • Fax: 484-947-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberDN006638
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: