Individual
MS. ALYSSA MARIE HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
921 S 8TH AVE STOP 8311, POCATELLO, ID 83209-8375
(208) 539-0186
Mailing address
921 S 8TH AVE STOP 8311, POCATELLO, ID 83209-8375
(208) 539-0186
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-991
ID
Other
Enumeration date
07/16/2018
Last updated
09/28/2020
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