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Individual

BLAKE DALY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RD

Contact information

Practice address
19333 BEAR VALLEY RD STE 103, APPLE VALLEY, CA 92308-5149
(714) 618-9500
Mailing address
415 SOUTH 28TH AVENUE HATTIESBURG, HATTIESBURG, MS 39401
(601) 579-5210
(601) 268-5733

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-2197
MS

Other

Enumeration date
06/26/2023
Last updated
05/07/2024
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