Individual
JODI ANN SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
54910, PINE CREST AVENUE, IDYLLWILD, CA 92549-9254
(951) 659-9912
Mailing address
54910, PINE CREST AVENUE, IDYLLWILD, CA 92549-9254
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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