Individual
MS. CHARLEEN M HEIDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
107 W FALLS ST, ITHACA, NY 14850-3212
(607) 227-5954
Mailing address
107 W FALLS ST, ITHACA, NY 14850-3212
(607) 227-5954
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
396146
NY
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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