Individual
MRS. KAYLEIGH RAVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
4 BARTON RD, PLATTSBURGH, NY 12901-7106
(518) 572-4996
Mailing address
4 BARTON RD, PLATTSBURGH, NY 12901-7106
(518) 572-4996
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
008013
NY
133V00000X
Registered Dietitian
Primary
19031024
NY
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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