Individual
KELLY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
1458 UNIVERSITY VLG, SALT LAKE CITY, UT 84108-3518
(951) 348-9725
Mailing address
1458 UNIVERSITY VLG, SALT LAKE CITY, UT 84108-3518
(951) 348-9725
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
02/11/2026
Last updated
02/11/2026
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