Individual
JESSICA SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CD
Contact information
Practice address
8 TH AVENUE AND C ST, SALT LAKE CITY, UT 84143-0001
(801) 408-1760
Mailing address
8 TH AVENUE AND C ST, SALT LAKE CITY, UT 84143-0001
(801) 408-1760
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1090399
UT
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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