Provider Demographics
NPI:1780349498
Name:REDD, AUBREY (MS, RDN)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:REDD
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 AMERICAN AVE APT A105
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4038
Mailing Address - Country:US
Mailing Address - Phone:484-523-2348
Mailing Address - Fax:
Practice Address - Street 1:560 AMERICAN AVE APT A105
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4038
Practice Address - Country:US
Practice Address - Phone:484-523-2348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered