Mallory Jean Jacobs, RD
Individual provider Active NPI Registered Dietitian · Auburn, MI
NPI 1851634679 · NPPES record last updated Mar 29, 2013
Key facts
- NPI
- 1851634679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 4681 Stephanie St
Auburn, MI 48611-9219 - Phone
- (989) 450-9118
- NPI assigned
- Mar 29, 2013
- Sex
- Female
- Sole proprietor
- Yes
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Yes |
Addresses
Primary practice location
4681 Stephanie St
Auburn, MI 48611-9219
Mailing address
4681 Stephanie St
Auburn, MI 48611-9219
Phone (989) 450-9118
Other providers in Auburn, MI
- Stephanie Hughes
- Carla Hunt
- Amy Jean Ingle
- Inspired by Jen
- Brandy Jacobs
- Jeffery T. Archbold DO
- Brooklynn Jonassen
- K. H. Counseling and Supervisory Service, LLC
- Jaclyn Kennedy
- Ronald V Klump
All providers in Auburn, MI · Registered Dietitian in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.