Provider Demographics
NPI:1114460458
Name:KNAPP, JUDITH (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:KNAPP
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2802
Mailing Address - Country:US
Mailing Address - Phone:410-746-7236
Mailing Address - Fax:410-859-1666
Practice Address - Street 1:1005 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5030
Practice Address - Country:US
Practice Address - Phone:410-746-7236
Practice Address - Fax:410-859-1666
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00019133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist