Individual
MS. VALORA JEAN TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
CORNER OF RT N12 & N7, FORT DEFIANCE, AZ 86504
(928) 729-8828
(928) 729-8045
Mailing address
PO BOX 589, FORT DEFIANCE, AZ 86504-0589
(928) 729-8828
(928) 729-8045
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0816
NM
133V00000X
Registered Dietitian
978588
IL
Other
Enumeration date
09/12/2008
Last updated
10/08/2014
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