| Doctor Name: | MRS. DIANA LEE GLICK |
| NPI Number: | 1841492113 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD,LDN |
| License Number: | ND1290 |
| Business Practice Address: | 12333 Nw 18th St Suite 3 Pembroke Pines, FL - 330264386 |
| Business Phone Number: | 9547044534 |
| Business Fax Number: | |
| Mailing Address: | 611 W 60th St, HIALEAH |
| State: | FL |
| Postal Code: | 330126547 |
| Phone Number: | 3058213813 |
| Fax Number: | |
| NPI Enumeration Date: | 05/31/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | ND1290 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |