Individual
DOMINIQUE ASHLEY RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
2850 W HORIZON RIDGE PKWY STE 200, HENDERSON, NV 89052-4395
(702) 485-7235
(833) 407-9212
Mailing address
2412 JUNIPER CANYON CT, LAS VEGAS, NV 89134-1836
(702) 279-2523
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
39929-DI-0
NV
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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