Individual
MRS. GINA MARIE MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
1067342
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1067342
REGISTERED DIETITIAN WITH COMMISSION ON DIETETIC REGISTRATION
CA
Enumeration date
05/04/2015
Last updated
05/04/2015
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