Individual
RAE ELIZAGARAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1500 JAMES SIMPSON JR WAY, COVINGTON, KY 41011-0801
(859) 655-8910
(859) 655-8911
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 655-8910
(859) 655-8911
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
122200
KY
Other
Enumeration date
05/02/2017
Last updated
09/13/2018
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