Individual
SUSAN MARIE ASHFORD TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
1219 ELM ST, SANDPOINT, ID 83864
(406) 570-8019
(208) 263-9747
Mailing address
1219 ELM ST, SANDPOINT, ID 83864
(406) 570-8019
(208) 263-9747
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
517257
MT
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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