Individual
KATRINA VANTASSEL MELEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
1061 HARMON AVE, FT STEWART, GA 31314-5604
(912) 435-6328
Mailing address
14 E SAYBROOK DR, GLENMONT, NY 12077-3061
(315) 254-7303
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
006954-1
NY
Other
Enumeration date
07/26/2005
Last updated
02/04/2017
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