Individual
STEPHANIE LAUREN PACKRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CLC
Contact information
Practice address
5640 MAIN ST, SUITE 100, NEW PORT RICHEY, FL 34652-2637
(727) 841-4425
(727) 841-4222
Mailing address
5640 MAIN ST, SUITE 100, NEW PORT RICHEY, FL 34652-2637
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 5655
FL
Other
Enumeration date
12/10/2009
Last updated
12/10/2009
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