Individual
MST SULTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 E BASELINE RD STE B-2, TEMPE, AZ 85283-1266
(602) 770-7611
Mailing address
2922 E EBONY DR, CHANDLER, AZ 85286-0012
(347) 475-2672
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1091872
NY
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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