Individual
DOMINICA WILHEMINA DIEFFENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3141 N 3RD AVE, PHOENIX, AZ 85013-4360
(602) 914-1520
(602) 266-0545
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
(602) 470-5064
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1004846
AZ
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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