Individual
MS. MARY ANN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
6448 HALLEE RD STE 9, JOSHUA TREE, CA 92252-1908
(760) 366-8390
(760) 418-2243
Mailing address
PO BOX 1357, JOSHUA TREE, CA 92252-0839
(760) 954-1308
(760) 418-2243
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
709057
IL
133N00000X
Nutritionist
709057
IL
133V00000X
Registered Dietitian
Primary
709057
IL
Other
Enumeration date
04/27/2007
Last updated
12/15/2020
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