Individual
SHELBY SHANABERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
300 E BANNOCK ST, BOISE, ID 83712-6207
(208) 342-1664
Mailing address
4031 E CONKLIN DR, MERIDIAN, ID 83646-7636
(509) 554-6186
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-832
ID
Other
Enumeration date
02/11/2015
Last updated
02/11/2015
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