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Individual
BRENDA SIS
Active
Individual
BRENDA SIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
252311
KY
133V00000X
Registered Dietitian
37003167A
IN
133V00000X
Registered Dietitian
LD.4976
OH
Other
Enumeration date
08/19/2019
Last updated
10/11/2023
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