Individual
MINDY COKER BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RD,CSSD,CPT
Contact information
Practice address
601 MAGNOLIA ST, NEPTUNE BEACH, FL 32266-3733
(904) 673-8329
Mailing address
601 MAGNOLIA ST, NEPTUNE BEACH, FL 32266-3733
(904) 673-8329
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
917545
FL
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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