Provider Demographics
NPI:1841562329
Name:KAPILA, MITALI (MSC, MS, RD)
Entity type:Individual
Prefix:MRS
First Name:MITALI
Middle Name:
Last Name:KAPILA
Suffix:
Gender:F
Credentials:MSC, MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 N MAIN ST STE 319
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1250
Mailing Address - Country:US
Mailing Address - Phone:248-961-0229
Mailing Address - Fax:248-319-0363
Practice Address - Street 1:340 N MAIN ST STE 319
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1250
Practice Address - Country:US
Practice Address - Phone:248-961-0229
Practice Address - Fax:248-319-0363
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered