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Dietary & Nutritional Service Providers Dietitian, Registered

Provider NPI: 1255731790

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
130 2ND ST  NEENAH, WI 54956-2883 US
Tel: 920-969-7900  Fax: --

Business Mailing Address:
130 2ND ST  NEENAH, WI 54956-2883 US
Tel: --  Fax: --

NPI Information:
NPI: 1255731790
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y133V00000XDietary & Nutritional Service Providers
Dietitian, Registered

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 133V00000X





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