MEDICARE: JACQUELINE ALLEN-REID RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	D1111	DC
2	133V00000X	Registered Dietitian	D01094	MD

General Provider Information

NPI Number	:	1720188394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE ALLEN-REID RD

Provider Business Mailing Address
First Line	:	4105 ULSTER RD
Second Line	:
City	:	BELTSVILLE
State	:	MD
Zip	:	20705-2868
Country	:	US
Telephone Number	:	240-286-5631
Fax Number	:

Provider Business Practice Location Address
First Line	:	12120 PLUM ORCHARD DR STE 140
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7820
Country	:	US
Telephone Number	:	301-572-2484
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	02/03/2026

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