Provider Demographics
NPI:1871099390
Name:OTT-SLENKER, JOANN (RD, LDN)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:OTT-SLENKER
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 1:555 N. DUKE STREET
Mailing Address - Street 2:ATTN: FOOD & NUTRITION SERVICES DEPT
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-3555
Mailing Address - Country:US
Mailing Address - Phone:717-544-7791
Mailing Address - Fax:
Practice Address - Street 1:555 N. DUKE STREET
Practice Address - Street 2:ATTN: FOOD & NUTRITION SERVICES DEPT
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17604-3555
Practice Address - Country:US
Practice Address - Phone:717-544-7791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004719174H00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator