Organization
BLAKELY BERRY NUTRITION AND WELLNESS
Active
Other names
Blakely Berry Dietetics and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKELY BERRY RDN/LD (REGISTERED DIETITIAN)
(405) 823-1077
Entity
Organization
Contact information
Practice address
6915 N CLASSEN BLVD STE C, OKLAHOMA CITY, OK 73116-7209
(405) 823-1077
Mailing address
1131 NW 38TH ST, OKLAHOMA CITY, OK 73118-5423
(405) 823-1077
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2139
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700339009
—
OK
Enumeration date
04/17/2018
Last updated
04/17/2018
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