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Individual

SAMANTHA ANN FISHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LD

Contact information

Practice address
30544 HIGHWAY 200 STE 103, PONDERAY, ID 83852-5005
(208) 946-5110
Mailing address
PO BOX 1633, SANDPOINT, ID 83864-0870
(208) 290-2849

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1162
ID

Other

Enumeration date
12/02/2020
Last updated
11/16/2021
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