Individual
MISS KATE MARIE VELAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
8111 S EMERSON AVE STE 150, INDIANAPOLIS, IN 46237-8601
(317) 528-1950
(317) 528-1960
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37002009A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37002009A
IN STATE LIC
IN
Enumeration date
06/30/2010
Last updated
01/02/2024
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