Alyssa Real

Individual provider Active NPI Registered Dietitian · Whiting, IN

NPI 1285440552 · NPPES record last updated Dec 10, 2024

Key facts

NPI
1285440552
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
Practice address
2028 Davidson PL
Whiting, IN 46394-2027
Phone
(708) 299-7362
NPI assigned
Dec 10, 2024
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 Yes

Addresses

Primary practice location

2028 Davidson PL
Whiting, IN 46394-2027

Mailing address

2028 Davidson PL
Whiting, IN 46394-2027
Phone (708) 299-7362

Other providers in Whiting, IN

All providers in Whiting, IN · Registered Dietitian in Indiana

Sources for this page

Verify at the official NPI Registry.