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Individual

ASHLEY MIKETINAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
270 ABNER JACKSON PKWY, LAKE JACKSON, TX 77566-5124
(979) 316-5100
Mailing address
270 ABNER JACKSON PKWY, LAKE JACKSON, TX 77566-5124

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86076194
133V00000X
Registered Dietitian
DT85949
TX

Other

Enumeration date
04/03/2026
Last updated
04/03/2026
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