Individual
KACEY ELIZABETH CONYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1270 KOTNUM RD, WARM SPRINGS, OR 97761
(541) 553-1196
(541) 553-2457
Mailing address
1270 KOTNUM RD, WARM SPRINGS, OR 97761
(541) 553-2457
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10163387
OR
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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