Individual
MAJEDAH Y KOETTER-ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
907 LYNDON LN, LOUISVILLE, KY 40222-3815
(502) 425-7659
(502) 425-7658
Mailing address
907 LYNDON LN, LOUISVILLE, KY 40222-3815
(502) 425-7659
(502) 425-7658
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
162884
KY
133V00000X
Registered Dietitian
BDNDTN00218429
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000945941
ANTHEM
KY
Enumeration date
05/04/2015
Last updated
12/22/2016
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