NPI 1407530173 · live from the CMS NPI Registry
Kristin Black, RD
Dietitian, Registered in Troy, MI. National Provider Identifier 1407530173, active.
NPI record
| NPI | 1407530173 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1934 Livernois Rd, Troy, MI 48083 |
| Practice phone | 248-686-0340 |
| Mailing address | 700 Ann St Apt 3, Birmingham, MI 48009 |
| Enumerated | June 13, 2023 |
| Last updated | June 13, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.