Individual
MARY GEORGIANA KIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
147 N BRENT ST, VENTURA, CA 93003-2809
(805) 652-5066
(805) 641-1706
Mailing address
147 N BRENT ST, VENTURA, CA 93003-2809
(805) 652-5066
(805) 641-1706
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
806071
CA
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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