Individual
AISHWARYA SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(405) 612-4012
Mailing address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2522
OK
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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