Individual
JULIE ANN MOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
728 S MADISON AVE, LA GRANGE, IL 60525-2805
(708) 945-0368
Mailing address
728 S MADISON AVE, LA GRANGE, IL 60525-2805
(708) 945-0368
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
164.001268
IL
Other
Enumeration date
08/26/2014
Last updated
06/30/2016
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