Provider Demographics
NPI:1952968109
Name:FELIX-MOTTLEY, ZELDA
Entity Type:Individual
Prefix:MRS
First Name:ZELDA
Middle Name:
Last Name:FELIX-MOTTLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 HILLANDALE RD
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-9630
Mailing Address - Country:US
Mailing Address - Phone:269-927-5674
Mailing Address - Fax:269-944-4128
Practice Address - Street 1:1737 HILLANDALE RD
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-9630
Practice Address - Country:US
Practice Address - Phone:269-927-5674
Practice Address - Fax:269-944-4128
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist