Individual
SIMRAN BHAKTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD, RDN, CLC
Contact information
Practice address
12481 N 57TH DR, GLENDALE, AZ 85304-1806
(623) 680-6421
Mailing address
12481 N 57TH DR, GLENDALE, AZ 85304-1806
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10234627
OR
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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