Individual
ANGELIQUE S CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.D.
Contact information
Practice address
7510 MONTGOMERY BLVD NE STE 203, ALBUQUERQUE, NM 87109-1500
(505) 855-5545
Mailing address
7510 MONTGOMERY BLVD NE STE 203, ALBUQUERQUE, NM 87109-1500
(505) 855-5545
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-0825
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD-0825
STATE OF NM BOARD OF NUTRITION PRACTITIONERS
NM
Enumeration date
09/13/2011
Last updated
06/12/2014
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