Individual
MICCA LYNN DONOHOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
701 N 1ST ST, FOOD AND NUTRITION OFFICE, SPRINGFIELD, IL 62781-0001
(217) 788-3477
(217) 788-5569
Mailing address
PO BOX 4488, SPRINGFIELD, IL 62708-4488
(800) 577-5368
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164003788
IL
Other
Enumeration date
10/31/2008
Last updated
02/03/2023
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