| Doctor Name: | MS. KATHLEEN A. FELLABAUM |
| NPI Number: | 1558420877 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D. |
| License Number: | NONE |
| Business Practice Address: | 6245 Inkster Rd Diabetes Self Mgmt Education, Garden City Hospital Garden City, MI - 481354001 |
| Business Phone Number: | 7344584330 |
| Business Fax Number: | 7344584690 |
| Mailing Address: | 5677 Winslow Ct, YPSILANTI |
| State: | MI |
| Postal Code: | 481979021 |
| Phone Number: | 7345289063 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2006 |
| NPI Last Update Date: | 02/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | NONE |
| 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 |