Individual
MICHELLE MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3802 MEADOWS LN, LAS VEGAS, NV 89107-3112
(702) 313-8446
(702) 221-8446
Mailing address
2345 E. PRATER WAY, SUITE 207, SPARKS, NV 89434
(775) 356-9393
(775) 356-5590
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86028933
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477963650
—
NV
Enumeration date
04/28/2014
Last updated
09/28/2017
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