Individual
AMELIA TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 VALLEY VIEW DR STE 104, MONTANA CITY, MT 59634-9203
(406) 459-6092
Mailing address
1188 GALESMORE CT, WESTLAKE VILLAGE, CA 91361-1647
(209) 402-1402
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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