NPI 1235743006

Jacqueline Odette, DTRCDMCFPP

Practitioner Registered Dietetic Technician Fairgrove, MI

Practice location

Address: 2328 N Thomas Rd, Fairgrove, MI 48733-9569
Phone: (989) 233-2373
Mailing address: 1285 Cleaver Rd, Caro, MI 48723-9241

Registered specialties

Registered Dietetic Technician Primary

Dietary & Nutritional Service Providers Taxonomy 136A00000X Licence 86198282 (MI)

Other Dietetic Technician, Registered providers in Michigan →

Registry record

NPI: 1235743006
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Aug 2020
Record last updated: 31 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.