Individual
MRS. TISH CHAMBRAE MAVIGLIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D., CDE
Contact information
Practice address
6525 U S HIGHWAY 60 W, SUITE 100, PADUCAH, KY 42001
(270) 217-9691
(270) 575-9515
Mailing address
3718 SPRINGDALE CIR, PADUCAH, KY 42001-5244
(270) 217-9691
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1034
KY
Other
Enumeration date
09/15/2006
Last updated
05/13/2009
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