Individual
MRS. KATIE RENE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
Mailing address
1841 BEARBERRY CIR, APT 203, LUTZ, FL 33559-8772
(775) 857-9136
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/05/2013
Last updated
12/03/2019
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