Individual
KELLY RENEE ROBERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDCES
Contact information
Practice address
15212 N 2ND ST, PHOENIX, AZ 85022-3610
(708) 469-9252
Mailing address
15212 N 2ND ST STE 4020, PHOENIX, AZ 85022-3610
(602) 935-8791
(833) 441-1808
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86023868
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86023868
LICENSE
AZ
Enumeration date
12/15/2014
Last updated
11/23/2021
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