Individual
MRS. JESSICA BADARACCO GRIFFEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
990 CESAR CHAVEZ AVE, POCATELLO, ID 83209-0001
(208) 282-2330
Mailing address
990 CESAR CHAVEZ AVE, POCATELLO, ID 83209-0001
(208) 282-2330
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
66610
MT
133V00000X
Registered Dietitian
86051010
ID
Other
Enumeration date
01/14/2018
Last updated
07/03/2018
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