Individual
MS. MARISA ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
13307 MIAMI LN, CALDWELL, ID 83607-4701
(208) 455-5335
(208) 455-5443
Mailing address
13307 MIAMI LN, CALDWELL, ID 83607-4701
(208) 455-5335
(208) 455-5443
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-801
ID
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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