Individual
NICOLE DESIREE LATTANZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
2158 N GILBERT RD, MESA, AZ 85203-2109
(480) 216-1635
Mailing address
1935 E 8TH ST, MESA, AZ 85203-6609
(480) 216-1635
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1104239
AZ
Other
Enumeration date
07/01/2013
Last updated
07/01/2013
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