Individual
KATIE BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MDA, RDN, SNS
Contact information
Practice address
7905 S REDWOOD RD, WEST JORDAN, UT 84088-4601
(801) 567-8602
Mailing address
13833 S OXFORDSHIRE DR, BLUFFDALE, UT 84065-6056
(801) 450-9901
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
7236722-4901
UT
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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