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General NPI Number Information
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NPI Number | 1659913622
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Entity Type | Individual
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Provider Name | JULIE FONTAINE APPOLONIA DTR
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Gender | Female
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | UNIVERSITY DRIVE C, MAIL STOP 120 NF-U
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City | PITTSBURGH
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State | PA
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Zip | 15240
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Country | US
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Telephone | 412-360-1184
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Fax |
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Provider Business Mailing Address
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Address Line | UNIVERSITY DRIVE C, MAIL STOP 120 NF-U
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City | PITTSBURGH
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State | PA
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Zip | 15240
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Country | US
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Telephone | 412-360-1184
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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 | 136A00000X
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Taxonomy Name | Registered Dietetic Technician
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License Number | 86021665
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License Number State |
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