Individual
COURTNEY RAE HEINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CMHIMP
Contact information
Practice address
884 ACID MINE RD, SULLIVAN, MO 63080-2695
(573) 619-5188
Mailing address
884 ACID MINE RD, SULLIVAN, MO 63080-2695
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2014012347
MO
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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