NPI 1114648524 · live from the CMS NPI Registry
Israa Alia, RDN
Dietitian, Registered, Nutrition, Gerontological in Grand Blanc, MI. National Provider Identifier 1114648524, active.
NPI record
| NPI | 1114648524 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered, Nutrition, Gerontological 133VN1101X |
| Practice location | 17303 Thornridge Dr, Grand Blanc, MI 48439 |
| Practice phone | 708-336-9330 |
| Enumerated | September 6, 2022 |
| Last updated | September 6, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Gerontological primary | 133VN1101X | 86040970 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.