Individual
LAURIE MIXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, HHP
Contact information
Practice address
15644 POMERADO RD, SUITE 304, POWAY, CA 92064-2400
(760) 315-1555
(760) 788-1659
Mailing address
15644 POMERADO RD, SUITE 304, POWAY, CA 92064-2400
(760) 315-1555
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
887748
CA
225700000X
Massage Therapist
Primary
CMT 735
CA
Other
Enumeration date
04/19/2007
Last updated
11/13/2013
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