| Doctor Name: | MRS. PETRA HAYLEY COLINDRES |
| NPI Number: | 1407232317 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA,RDN/LD,IBCLC,CPT |
| License Number: | |
| Business Practice Address: | 4129 Nw 45th St Okc, OK - 73112 |
| Business Phone Number: | 8583528354 |
| Business Fax Number: | |
| Mailing Address: | 4129 Nw 45th St, OKC |
| State: | OK |
| Postal Code: | 73112 |
| Phone Number: | 8583528354 |
| Fax Number: | |
| NPI Enumeration Date: | 08/03/2015 |
| NPI Last Update Date: | 11/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |