Individual
KIMBERLY NISHIYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DTR
Contact information
Practice address
20325 N 51ST AVE, GLENDALE, AZ 85308-5674
(602) 341-5248
Mailing address
20325 N 51ST AVE STE 166, GLENDALE, AZ 85308-4624
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
86092429
AZ
Other
Enumeration date
06/01/2018
Last updated
06/01/2018
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