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Individual

MRS. CRYSTAL DAWN PELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, CDCES, LD

Contact information

Practice address
2403 W MAIN ST, HENRYETTA, OK 74437-3893
(918) 218-7505
Mailing address
707 SW 5TH ST, CHECOTAH, OK 74426-4419
(918) 689-0055

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1542
OK

Other

Enumeration date
05/17/2022
Last updated
05/17/2022
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