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NPI 1700919065

NPI 1700919065 : MELISSA T. BENZON RD : CHAMBERSBURG, PA

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General NPI Number Information
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    NPI Number           |    1700919065
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA T. BENZON RD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/14/2007
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    Last Update Date     |    08/03/2022
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Provider Practice Location Address
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    Address Line         |    12 ST PAUL DR STE 210 
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    City                 |    CHAMBERSBURG
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    State                |    PA
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    Zip                  |    17201-1035
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    Country              |    US
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    Telephone            |    717-217-6820
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    Fax                  |    717-217-6942
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Provider Business Mailing Address
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    Address Line         |    785 5TH AVENUE SUITE 3
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    City                 |    CHAMBERSBURG
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    State                |    PA
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    Zip                  |    17201-4232
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    Country              |    US
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    Telephone            |    717-263-9555
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    Fax                  |    717-217-4217
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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        |    133VN1006X
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    Taxonomy Name        |    Metabolic Nutrition Registered Dietitian
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    License Number       |    922760
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    DN003025
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    License Number State |    PA
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Taxonomy #3
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    Taxonomy Code        |    133NN1002X
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    Taxonomy Name        |    Nutrition Education Nutritionist
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    License Number       |    DN003025
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    License Number State |    PA
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