Individual
MRS. KELLY SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
6433 W PARK AVE, HOUMA, LA 70364-2238
(985) 851-0188
Mailing address
3379 BROOKWOOD DR, HOUMA, LA 70360
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2868
LA
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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