Individual
SANDRA GAY MINIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
600 EAST BLVD, DEPT OF NUTRITION, ELKHART, IN 46514-2483
(574) 524-7474
(574) 296-6504
Mailing address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 524-7474
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002665
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD002665
LICENSED DIETITIAN
GA
Enumeration date
06/09/2006
Last updated
11/25/2013
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