Mia Abram, RD

Individual provider Active NPI Registered Dietitian · Phoenix, AZ

NPI 1144929522 · NPPES record last updated Feb 24, 2023

Key facts

NPI
1144929522
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86171865
Practice address
2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone
(602) 344-5125
NPI assigned
Feb 24, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86171865 Yes

Addresses

Primary practice location

2525 E Roosevelt St
Phoenix, AZ 85008-4948

Mailing address

2019 E Turney Ave Apt 3
Phoenix, AZ 85016-5539
Phone (805) 459-3623

Other providers in Phoenix, AZ

All providers in Phoenix, AZ · Registered Dietitian in Arizona

Sources for this page

Verify at the official NPI Registry.