Individual
ANDREA DUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-9215
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1014
ID
Other
Enumeration date
06/21/2018
Last updated
11/23/2021
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