Individual
MS. KARISSA SUZANNE HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
1101 CLUB VILLAGE DR, SUITE 101, COLUMBIA, MO 65203-4410
(573) 447-4400
Mailing address
6025 S HIGHWAY KK, COLUMBIA, MO 65203-9475
(573) 424-8064
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2009005906
MO
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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