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Individual
KELLY RYAN MALONE
Active
Individual
KELLY RYAN MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RD, LDN
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
979040
NC
133V00000X
Registered Dietitian
Primary
979040
NC
133VN1006X
Metabolic Nutrition Registered Dietitian
979040
NC
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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