Individual
MRS. MIRANDA KATELYNN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
4603 TIMBERWALK CT, LA GRANGE, KY 40031-6746
(703) 864-6695
(888) 830-3233
Mailing address
7113 GREEN SPRING DR, LOUISVILLE, KY 40241-1016
(502) 539-4767
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
124585
KY
Other
Enumeration date
03/01/2018
Last updated
03/27/2020
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