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Organization
DESERT DIETITIANS LLC
Active
Organization
DESERT DIETITIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE INGENITO (CREDENTIALING SPECIALISTS)
(570) 352-3063
Entity
Organization
Contact information
Practice address
2470 W HORIZON RIDGE PKWY STE 120, HENDERSON, NV 89052-2733
(608) 206-4837
Mailing address
7073 LEADVILLE PEAK AVE, LAS VEGAS, NV 89179-1503
(608) 206-4837
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
07/20/2018
Last updated
04/05/2022
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