Individual
KELLIE HALLARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
101 W. LIBERTY STREET, SUITE 360, SUITE 360, ANN ARBOR, MI 48104-4810
(248) 444-2164
Mailing address
30361 BALFOUR DRIVE, NOVI, MI 48377
(248) 444-2164
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
15707
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15707
ACADEMY OF NUTRITION AND DIETETICS
MI
Enumeration date
05/29/2019
Last updated
05/29/2019
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