NPI 1316505811

Tia Jackson

Practitioner Registered Dietitian Beavercreek, OH

Practice location

Address: 2510 Commons Blvd STE 130, Beavercreek, OH 45431-3820
Phone: (937) 558-3064

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence LD.8212 (OH)

Other Dietitian, Registered providers in Ohio →

Registry record

NPI: 1316505811
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 May 2019
Record last updated: 31 May 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.