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Individual

DEBRA LYNN AMICK-SUESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, CDE

Contact information

Practice address
47923 OASIS ST, INDIO, CA 92201-9788
(760) 863-8265
(760) 863-8598
Mailing address
PO BOX 7849, RIVERSIDE, CA 92513-7849

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
706587
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2041-0395
NCBDE
CA
01
706587
CDR
CA
Enumeration date
01/15/2008
Last updated
01/15/2008
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