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Individual

AMBER MARIE HISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
71 SHETLER DR, COLEVILLE, CA 96107-9758
(208) 916-6233
Mailing address
71 SHETLER DR, COLEVILLE, CA 96107-9758
(208) 916-6233

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1089658
ID

Other

Enumeration date
08/10/2020
Last updated
08/10/2020
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