Individual
MRS. JENNIE J GUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RND
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1082914
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1082914
COMMISSION ON DIETITI REGISTRATION
AZ
Enumeration date
01/12/2015
Last updated
01/12/2015
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