Individual
MS. KATHLEEN A. FELLABAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
6245 INKSTER RD, DIABETES SELF MGMT EDUCATION, GARDEN CITY HOSPITAL, GARDEN CITY, MI 48135-4001
(734) 458-4330
(734) 458-4690
Mailing address
5677 WINSLOW CT, YPSILANTI, MI 48197-9021
(734) 528-9063
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
NONE
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578550174
GARDEN CITY HOSPITAL NPI
MI
Enumeration date
12/06/2006
Last updated
02/21/2013
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