Doctor Name: | MS. JACQUELINE MARY MAILLET |
NPI Number: | 1104802537 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 439 |
Business Practice Address: | 468 74th St N Malmstrom Afb, Health And Wellness Center Great Falls, MT - 594026780 |
Business Phone Number: | 4067312404 |
Business Fax Number: | |
Mailing Address: | 12647 Olive Blvd, SAINT LOUIS |
State: | MO |
Postal Code: | 631416345 |
Phone Number: | 8003253982 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 439 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
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 |