Individual
JACQUELINE GODINEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
20325 N 51ST AVE STE 166, GLENDALE, AZ 85308-4624
(602) 341-5248
Mailing address
20325 N 51ST AVE STE 166, GLENDALE, AZ 85308-4624
(602) 341-5248
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86068218
AZ
Other
Enumeration date
07/13/2020
Last updated
01/26/2021
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