| Doctor Name: | JACLYN BART |
| NPI Number: | 1548652779 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD |
| License Number: | 1079590 |
| Business Practice Address: | 1851 Mesquite Ave Suite 216 Lake Havasu City, AZ - 864035677 |
| Business Phone Number: | 9288545358 |
| Business Fax Number: | 9288545367 |
| Mailing Address: | 3003 N Central Ave, Suite 400 PHOENIX |
| State: | AZ |
| Postal Code: | 850122902 |
| Phone Number: | 6023513120 |
| Fax Number: | 6022243358 |
| NPI Enumeration Date: | 02/25/2015 |
| NPI Last Update Date: | 02/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 1079590 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| 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 |