Provider Demographics
NPI:1568647329
Name:YOST, SUZANNE M (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:M
Last Name:YOST
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 1:2672 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-2845
Mailing Address - Country:US
Mailing Address - Phone:610-336-4974
Mailing Address - Fax:
Practice Address - Street 1:2672 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069-2845
Practice Address - Country:US
Practice Address - Phone:610-336-4974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001564133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered