Individual
KENDALL L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-0935
(602) 933-0610
Mailing address
1919 E THOMAS RD, BLDG 2108, SUITE 101, PHOENIX, AZ 85016-7710
(602) 512-8030
(602) 512-8161
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
934425
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
751126
—
AZ
Enumeration date
10/12/2012
Last updated
12/28/2012
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