Individual
SONAMARIVELL GRANADOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-4120
(208) 814-4906
Mailing address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-4120
(208) 814-4906
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1010
ID
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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