Individual
JACLYN BART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
8415 N PIMA RD, SUITE 150, SCOTTSDALE, AZ 85258-4480
(480) 551-1057
(480) 551-1059
Mailing address
3333 E CAMELBACK RD, SUITE 180, PHOENIX, AZ 85018-2322
(602) 997-0484
(602) 224-3358
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1079590
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
989536
—
AZ
Enumeration date
02/25/2015
Last updated
08/23/2016
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