Individual
MIKAELA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
385 E 200 S, LOGAN, UT 84321-5305
(435) 231-9299
Mailing address
385 E 200 S, LOGAN, UT 84321-5305
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
02/07/2026
Last updated
02/07/2026
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