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Individual
KELLY CARPENTER
Active
Individual
KELLY CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
863763
—
AZ
Enumeration date
08/25/2005
Last updated
05/05/2008
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