Individual
KELLY STAPLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3630 E IMPERIAL HWY, LYNWOOD, CA 90262-2609
(310) 900-7867
Mailing address
6100 S PACIFIC COAST HWY APT 14, REDONDO BEACH, CA 90277-5957
(617) 224-3923
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
86018613
CA
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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