Provider Demographics
NPI:1164933388
Name:DANT, JAMIE REISINGER (CNS, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:REISINGER
Last Name:DANT
Suffix:
Gender:F
Credentials:CNS, LDN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ANTOINETTE
Other - Last Name:REISINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNS, LDN
Mailing Address - Street 1:4970 WALKING STICK RD APT B
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-8056
Mailing Address - Country:US
Mailing Address - Phone:410-409-2290
Mailing Address - Fax:
Practice Address - Street 1:9449 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2803
Practice Address - Country:US
Practice Address - Phone:240-339-3268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3809133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist