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Individual

KIRSTEN NICOLE MELLOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDN

Contact information

Practice address
155 CALLE PORTAL STE 700, SIERRA VISTA, AZ 85635-2973
(520) 459-0203
(520) 459-3159
Mailing address
1205 N F AVE, DOUGLAS, AZ 85607-1920
(520) 364-1429
(520) 515-8690

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86154717
AZ

Other

Enumeration date
07/21/2021
Last updated
07/03/2024
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