Individual
MACKENZIE ANNE BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN00993
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86099726
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
11/19/2018
Last updated
12/28/2018
Update your record
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