Individual
MISS RIESA SHANNON RARICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
5000 S 5TH AVE, HINES VA HOSPITAL, NUTRITION AND FOOD SERVICES (120D), HINES, IL 60141-3030
(708) 202-7354
Mailing address
5000 S 5TH AVE, HINES VA HOSPITAL, NUTRITION AND FOOD SERVICES (120D), HINES, IL 60141-3030
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/20/2010
Last updated
05/10/2011
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