Individual
MRS. TINA H WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RD, CD
Contact information
Practice address
8402 HARCOURT RD, STE 500, INDIANAPOLIS, IN 46260-2074
(317) 871-0000
(317) 871-0010
Mailing address
8402 HARCOURT RD, STE 500, INDIANAPOLIS, IN 46260-2074
(317) 871-0000
(317) 871-0010
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
875565
IN
Other
Enumeration date
01/05/2010
Last updated
01/05/2010
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