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Individual

KIRSTEN WASSUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1492 S MILL AVE, SUITE 312, TEMPE, AZ 85281-5652
(602) 243-7277
(480) 927-1092
Mailing address
2702 N 3RD ST, SUITE 4020, PHOENIX, AZ 85004-1130
(602) 323-3393
(602) 323-3399

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86012086
AZ

Other

Enumeration date
09/21/2015
Last updated
04/04/2017
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