Sydney Nicole Mitcheltree, DTR

Individual provider Active NPI Registered Dietetic Technician · Moon TWP, PA

NPI 1366072191 · NPPES record last updated Jan 21, 2020

Key facts

NPI
1366072191
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietetic Technician 136A00000X
Practice address
111 Idleworth Dr
Moon TWP, PA 15108-1008
Phone
(412) 445-2627
NPI assigned
Jan 21, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietetic Technician 136A00000X Yes

Addresses

Primary practice location

111 Idleworth Dr
Moon TWP, PA 15108-1008

Mailing address

111 Idleworth Dr
Moon TWP, PA 15108-1008
Phone (412) 445-2627

Other providers in Moon TWP, PA

All providers in Moon TWP, PA · Registered Dietetic Technician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.