Individual
HAILEY VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
144 STONY POINT RD, SANTA ROSA, CA 95401-4122
(707) 521-4678
Mailing address
1411 CONCORD ST, UKIAH, CA 95482-3209
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86153535
AL
Other
Enumeration date
05/07/2022
Last updated
05/07/2022
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