Provider Demographics
NPI:1710380597
Name:MIGLIORETTI, MARA CECILE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:MARA
Middle Name:CECILE
Last Name:MIGLIORETTI
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 1:524 MAIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:PA
Mailing Address - Zip Code:16037-6828
Mailing Address - Country:US
Mailing Address - Phone:724-816-0769
Mailing Address - Fax:
Practice Address - Street 1:524 MAIN ST APT 1
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:PA
Practice Address - Zip Code:16037-6828
Practice Address - Country:US
Practice Address - Phone:724-816-0769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005463133N00000X
PA1064141133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist