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NPI Code Detail

MEDICARE: MOM'S VALET DASH, LLC

MEDICARE: MOM'S VALET DASH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1811750334
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOM'S VALET DASH, LLC
Provider Business Mailing Address
First Line : 1910 MADISON AVE # 3052
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-2620
Country : US
Telephone Number : 615-686-6787
Fax Number :
Provider Business Practice Location Address
First Line : 12701 SACRED OAK CV
Second Line :
City : ARLINGTON
State : TN
Zip : 38002-5057
Country : US
Telephone Number : 615-686-6787
Fax Number :
Authorized Official
Title or Position : OWNER/FOUNDER
Name : MRS. MIRIAM BOUTTE
Credential : RDN
Telephone Number : 615-686-6787
Provider Enumeration Date : 02/06/2024
Last Update Date : 10/31/2025

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Directions to “MOM'S VALET DASH, LLC ” Practice Location

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