Provider Demographics
NPI:1194450494
Name:NEAL, ALLISON JADE (RD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JADE
Last Name:NEAL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 N ARSENAL AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201-1131
Mailing Address - Country:US
Mailing Address - Phone:812-830-9944
Mailing Address - Fax:
Practice Address - Street 1:1980 E 116TH ST STE 120B
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3515
Practice Address - Country:US
Practice Address - Phone:812-830-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered