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General NPI Number Information
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NPI Number | 1699196428
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Entity Type | Individual
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Provider Name | ALEXIS DARNELL MOTLEY MS, RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 02/03/2019
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Provider Practice Location Address
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Address Line | 1115 E 7TH AVE
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City | OAKDALE
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State | LA
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Zip | 71463-2301
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Country | US
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Telephone | 318-485-9238
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Fax |
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Provider Business Mailing Address
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Address Line | 148 DOUGLAS MEMORIAL RD
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City | LEESVILLE
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State | LA
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Zip | 71446-5404
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Country | US
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Telephone | 318-485-9238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1106397
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 1106397
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License Number State |
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