Doctor Name: | MS. BANDY JO RACKLEY |
NPI Number: | 1033188743 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, LD |
License Number: | DT06843 |
Business Practice Address: | 12647 Olive Blvd Suite 600 Saint Louis, MO - 631416345 |
Business Phone Number: | 3147444100 |
Business Fax Number: | |
Mailing Address: | 7750 Culebra Rd, Apt 1133 SAN ANTONIO |
State: | TX |
Postal Code: | 782511468 |
Phone Number: | 5806479442 |
Fax Number: | |
NPI Enumeration Date: | 03/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | DT06843 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |