Individual
MRS. KELLY WYNNE MINARICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, RDN, LDN
Contact information
Practice address
650 WARRENVILLE RD STE 100, LISLE, IL 60532-4315
(847) 318-3013
(833) 290-5413
Mailing address
17060 DALLAS PKWY STE 112, DALLAS, TX 75248-1905
(469) 372-2022
(833) 290-5413
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.007272
IL
Other
Enumeration date
05/23/2022
Last updated
03/21/2024
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