Jessica Provost, RD, LD

NPI #1508413493 in Prairie Village, Kansas

Provider Information

NPI Number
1508413493
Entity Type
Individual
Name
Jessica Provost, RD, LD
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dietitian, Registered
Credential
RD, LD
Enumeration Date
Aug 24, 2019
Last Updated
Aug 24, 2019

Practice Location

Address
3506 W 78TH ST
State
Kansas
ZIP Code
66208-4032
Phone
(913) 927-9116

Specialties & Taxonomy Codes

Specialty
Dietitian, Registered

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