Individual
SUSAN REESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RDN CNSC CD
Contact information
Practice address
2147 E PINNACLE TERRACE WAY, APT 103, SALT LAKE CITY, UT 84121-5062
(801) 201-1850
Mailing address
PO BOX 711913, SALT LAKE CITY, UT 84171-1913
(801) 201-1850
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
8066413-4901
UT
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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