Individual
KEISHA ANGELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-4126
Mailing address
445 LACASA LOOP, TWIN FALLS, ID 83301-5663
(208) 351-6479
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-842
ID
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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