NPI 1902282015 · live from the CMS NPI Registry
Adult Well-Being Services
Dietitian, Registered in Detroit, MI. National Provider Identifier 1902282015, active.
NPI record
| NPI | 1902282015 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1423 Field St, Detroit, MI 48214 |
| Practice phone | 313-825-2410 |
| Enumerated | July 31, 2015 |
| Last updated | July 21, 2022 |
| Authorized official | Dawn Rucker, Intrim President & Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.