Individual
BETHANY ANNE HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
1319 W WILLIAMS ST, BOISE, ID 83706-3569
(208) 269-8125
Mailing address
1319 W WILLIAMS ST, BOISE, ID 83706-3569
(208) 269-8125
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1593
ID
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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