Individual
MELANIE SHAY COLVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
222 W THOMAS RD, SUITE 304, PHOENIX, AZ 85013-4419
(602) 406-3611
(602) 406-4363
Mailing address
222 W THOMAS RD, SUITE 304, PHOENIX, AZ 85013-4419
(602) 406-3611
(602) 406-4363
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
886208
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
07/01/2009
Last updated
07/01/2009
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