Individual
BAILEY PERSONETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
Mailing address
5409 OSAGE LAKE DR APT 2A, MISHAWAKA, IN 46545-1288
(574) 261-2035
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86067213
IN
Other
Enumeration date
11/26/2019
Last updated
11/26/2019
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