Provider Demographics
NPI:1972636991
Name:KILATES, MARIA CRISTINA I (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CRISTINA
Last Name:KILATES
Suffix:I
Gender:F
Credentials:REGISTERED DIETITIAN
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Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:CLARA FORD PAVILION ROOM 547
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-2705
Mailing Address - Fax:313-916-2554
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:CLARA FORD PAVILION ROOM 547
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-2705
Practice Address - Fax:313-916-2554
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered