Individual
MEGAN M. KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1055 N 500 W BLDG A, PROVO, UT 84604-3305
(801) 812-5033
Mailing address
1055 N. 500 W., ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10533307-4901
UT
Other
Enumeration date
10/23/2017
Last updated
10/23/2017
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