Individual
MS. AMANDA J VILLESCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
20411 W 12 MILE RD, SOUTHFIELD, MI 48076-5414
(866) 703-1901
Mailing address
20411 W 12 MILE RD, SOUTHFIELD, MI 48076-5414
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1003176
MI
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/05/2012
Last updated
09/08/2024
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