Individual
ANGELA LYNN THOMASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
405 POLK ST, BELLEVILLE, IL 62220-2441
(618) 239-0553
Mailing address
405 POLK ST, BELLEVILLE, IL 62220-2441
(618) 239-0553
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
164.003677
IL
Other
Enumeration date
01/31/2008
Last updated
11/10/2009
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