Individual
KIMBERLY MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
17505 N 79TH AVE, SUITE 407, GLENDALE, AZ 85308-8725
(623) 399-6825
(623) 505-3474
Mailing address
17505 N 79TH AVE, SUITE 210, GLENDALE, AZ 85308-8725
(623) 399-6825
(623) 505-3474
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1054529
IL
Other
Enumeration date
05/12/2014
Last updated
05/12/2014
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