Individual
KELLY V TSOUGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D., L.D.N
Contact information
Practice address
5410 S ASHCROFT WAY, MERIDIAN, ID 83642-6866
(919) 601-3919
(919) 705-1626
Mailing address
5410 S ASHCROFT WAY, MERIDIAN, ID 83642-6866
(919) 601-3919
(919) 705-1626
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164008832
IL
133V00000X
Registered Dietitian
2713
KS
133V00000X
Registered Dietitian
40194-DI-0
NV
Other
Enumeration date
03/16/2010
Last updated
06/29/2023
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