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Individual

MRS. MARY NIERAETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
8311 FLORENCE AVE, DOWNEY, CA 90240-3928
(562) 943-4911
Mailing address
5600 WAGNER AVE, LAKEWOOD, CA 90712-1467
(562) 999-6993

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
535763
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
535763
CA
Enumeration date
06/30/2016
Last updated
06/30/2016
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