Individual
BAILEY LYNN SHUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
9012 E HANNIBAL ST, MESA, AZ 85207-4234
(480) 459-1601
Mailing address
9012 E HANNIBAL ST, MESA, AZ 85207-4234
(480) 459-1601
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86011741
AZ
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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