Individual
AMANDA REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
250 HOSPITAL PL, SOLDOTNA, AK 99669-6999
(907) 714-4752
Mailing address
250 HOSPITAL PL, SOLDOTNA, AK 99669-6999
(907) 714-4502
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86104469
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86104469
COMMISSION ON DIETETIC REGISTRATION I.D. NUMBER
CA
Enumeration date
02/09/2021
Last updated
05/03/2021
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