Individual
KELLI SHALLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2574 E JASPER DR, GILBERT, AZ 85296-8914
(602) 299-6006
Mailing address
2574 E JASPER DR, GILBERT, AZ 85296-8914
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86003199
AZ
Other
Enumeration date
05/19/2016
Last updated
08/22/2022
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