Individual
MS. LEILANI DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
1260 S LINDSAY RD, 39, MESA, AZ 85204-6219
(480) 813-2055
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
809914
AZ
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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