Individual
MS. SUSANNE E CONSIGLIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
22811 GREATER MACK AVE, SUITE 105, SAINT CLAIR SHORES, MI 48080-2021
(586) 778-4877
(586) 778-3004
Mailing address
22811 GREATER MACK AVE, SUITE 105, SAINT CLAIR SHORES, MI 48080-2021
(586) 778-4877
(586) 778-3004
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
R00595403
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N39270
MEDICAN PIN
MI
Enumeration date
07/06/2006
Last updated
07/08/2007
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