Individual
IRIS JAQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(405) 271-8001
Mailing address
505 E SHERIDAN AVE APT 2438, OKLAHOMA CITY, OK 73104-6740
(580) 528-1818
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1985
OK
Other
Enumeration date
12/18/2019
Last updated
12/18/2019
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