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General NPI Number Information
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NPI Number | 1801305669
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Entity Type | Individual
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Provider Name | LAUREN KATE PELLIZZON MS RD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 09/25/2017
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Provider Practice Location Address
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Address Line | 1920 N HIGLEY RD STE 306
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City | GILBERT
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State | AZ
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Zip | 85234-1625
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Country | US
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Telephone | 480-543-2606
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Fax |
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Provider Business Mailing Address
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Address Line | 8021 E OSBORN RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4876
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Country | US
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Telephone | 909-438-5988
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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 | 86061678
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License Number State |
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