Provider Demographics
NPI:1083099006
Name:TIELSCH, JOYCE (RD LDN)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:TIELSCH
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 JAMIE DR
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-4317
Mailing Address - Country:US
Mailing Address - Phone:724-825-7719
Mailing Address - Fax:
Practice Address - Street 1:421 JAMIE DR
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-4317
Practice Address - Country:US
Practice Address - Phone:724-825-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000866133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered