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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LD

Contact information

Practice address
3322 S. CAMPBELL AVE. SUITE CC, SPRINGFIELD, MO 65807
(417) 719-1700
(417) 815-6191
Mailing address
1104 S RED CEDAR AVE, SPRINGFIELD, MO 65802-5857
(417) 569-6788

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2012010024
MO

Other

Enumeration date
03/05/2019
Last updated
04/11/2023
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