Provider Demographics
NPI:1639592942
Name:BAKER, JULIA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:GROCKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:241 HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CATAWISSA
Mailing Address - State:PA
Mailing Address - Zip Code:17820-7805
Mailing Address - Country:US
Mailing Address - Phone:570-878-9623
Mailing Address - Fax:
Practice Address - Street 1:241 HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CATAWISSA
Practice Address - State:PA
Practice Address - Zip Code:17820-7805
Practice Address - Country:US
Practice Address - Phone:570-878-9623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004439133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered