Individual
MRS. KRISTIN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CDN
Contact information
Practice address
149 LARKIN AVE, CANASTOTA, NY 13032-4276
(315) 380-6968
Mailing address
149 LARKIN AVE, CANASTOTA, NY 13032-4276
(315) 380-6968
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
005851-1
NY
Other
Enumeration date
03/28/2019
Last updated
05/17/2024
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