Individual
DAWN LARA PRIVETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1214 W 25TH TER S, INDEPENDENCE, MO 64052-3210
(816) 719-2743
Mailing address
1214 W 25TH TER S, INDEPENDENCE, MO 64052-3210
(816) 719-2743
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
20000171728
MO
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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