Individual
TAKARA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
121 SIS LN, CARENCRO, LA 70520-6147
(337) 303-8134
Mailing address
121 SIS LN, CARENCRO, LA 70520-6147
(337) 303-8134
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2061
LA
133V00000X
Registered Dietitian
Primary
DT83241
TX
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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