Provider Demographics
NPI:1437628823
Name:TWEDT, MELISSA WILSON (MS, CNS, LDN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:WILSON
Last Name:TWEDT
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 MILES RD STE E
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1929
Mailing Address - Country:US
Mailing Address - Phone:610-696-1860
Mailing Address - Fax:484-947-5606
Practice Address - Street 1:780 MILES RD STE E
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-1929
Practice Address - Country:US
Practice Address - Phone:610-696-1860
Practice Address - Fax:484-947-5606
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006638133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education