Provider Demographics
NPI:1154751725
Name:AGLI, JOANNA (NUTRITIONIST)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:AGLI
Suffix:
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 BAYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-2805
Mailing Address - Country:US
Mailing Address - Phone:856-343-8058
Mailing Address - Fax:
Practice Address - Street 1:1054 BAYWOOD DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-2805
Practice Address - Country:US
Practice Address - Phone:856-343-8058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist