Individual
KELLY S. VANDAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 EXECUTIVE DR STE F, LAFAYETTE, IN 47905-4864
(765) 201-0502
Mailing address
5134 FLORENCE LN, LAFAYETTE, IN 47905-7741
(765) 413-5609
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
02/24/2021
Last updated
05/28/2024
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