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General NPI Number Information
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NPI Number | 1427310101
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Entity Type | Individual
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Provider Name | JONI RICHELLE BRODE RD,LD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 12501 WILLOWBROOK RD FL 2
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City | CUMBERLAND
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State | MD
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Zip | 21502-2506
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Country | US
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Telephone | 240-964-8434
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Fax | 240-964-8231
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Provider Business Mailing Address
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Address Line | 198 MCCULLOH ST
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City | FROSTBURG
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State | MD
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Zip | 21532-1956
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Country | US
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Telephone | 301-689-3526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | D01023
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License Number State | MD
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