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General NPI Number Information
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NPI Number | 1740282821
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Entity Type | Organization
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Legal Business Name | ARIZONA DIABETES AND NUTRITION EDUCATION, LLC
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3707 E SOUTHERN AVE
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City | MESA
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State | AZ
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Zip | 85206-2569
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Country | US
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Telephone | 480-217-4861
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Fax | 480-626-1551
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Provider Business Mailing Address
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Address Line | 3707 E SOUTHERN AVE
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City | MESA
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State | AZ
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Zip | 85206-2569
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Country | US
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Telephone | 480-217-4861
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Fax | 480-626-1551
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MRS. BARBARA ANN MALAJ
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Credential |
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Telephone | 480-217-4861
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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 | 706851
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | RN0518449
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License Number State | AZ
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