Individual
MRS. KELLY ANN BAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
175 STRAFFORD AVE STE 1, WAYNE, PA 19087-3340
(484) 253-1082
Mailing address
175 STRAFFORD AVE STE 1, WAYNE, PA 19087-3340
(484) 253-1082
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004453
PA
Other
Enumeration date
11/11/2010
Last updated
11/21/2018
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