Doctor Name: | JILLIAN TACIA |
NPI Number: | 1497104616 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D. |
License Number: | |
Business Practice Address: | 25710 Kelly Rd Suite 3 Roseville, MI - 480664959 |
Business Phone Number: | 5867722600 |
Business Fax Number: | 5867725289 |
Mailing Address: | 25710 Kelly Rd, Suite 3 ROSEVILLE |
State: | MI |
Postal Code: | 480664959 |
Phone Number: | 5867722600 |
Fax Number: | 5867725289 |
NPI Enumeration Date: | 06/08/2016 |
NPI Last Update Date: | 06/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |