Provider Demographics
NPI:1932748381
Name:SOTO MARTINEZ, KARINA NAYELI (MCN, RD, LD)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:NAYELI
Last Name:SOTO MARTINEZ
Suffix:
Gender:F
Credentials:MCN, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 BRENTFORD PL APT 105
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-2528
Mailing Address - Country:US
Mailing Address - Phone:786-961-3002
Mailing Address - Fax:
Practice Address - Street 1:723 BRENTFORD PL APT 105
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-2528
Practice Address - Country:US
Practice Address - Phone:786-961-3002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85815133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered