Individual
MRS. CASSI MENDIOLA WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-4011
Mailing address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-4011
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86013281
ID
Other
Enumeration date
08/01/2013
Last updated
10/19/2016
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