Provider Demographics
NPI:1538643499
Name:YODER, JENNIFER (RDN, LD, CT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:YODER
Suffix:
Gender:F
Credentials:RDN, LD, CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-0188
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-773-4426
Practice Address - Street 1:9 KENNY DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-9406
Practice Address - Country:US
Practice Address - Phone:740-589-5132
Practice Address - Fax:740-593-6129
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OH7050133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered