Individual
MISS NICOLE DION SANTONASTASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CLC, IBCLC, CDE
Contact information
Practice address
1920 E CAMBRIDGE AVE, PHOENIX, AZ 85006-1459
(602) 933-0618
Mailing address
3200 E CAMELBACK RD STE 250, PHOENIX, AZ 85018-2327
(602) 933-1813
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
374J00000X
Doula
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529668
—
AZ
Enumeration date
04/12/2019
Last updated
08/06/2019
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