Doctor Name: | MARYBETH CLARK |
NPI Number: | 1780613141 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, RD |
License Number: | 923323 |
Business Practice Address: | 2121 E Flamingo Rd Suite 114 Las Vegas, NV - 891195122 |
Business Phone Number: | 7023828841 |
Business Fax Number: | 7023692370 |
Mailing Address: | 6273 Dean Martin Dr, LAS VEGAS |
State: | NV |
Postal Code: | 891183833 |
Phone Number: | 7026161605 |
Fax Number: | 7026160967 |
NPI Enumeration Date: | 06/30/2006 |
NPI Last Update Date: | 01/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 923323 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
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 |