Individual
EMMA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
900 N ORANGE ST STE 304, MISSOULA, MT 59802-2951
(406) 329-5781
(406) 327-3331
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 329-5781
(406) 327-3331
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
69119
MT
133V00000X
Registered Dietitian
Primary
MED-NUTR-LIC-69119
MT
Other
Enumeration date
10/12/2018
Last updated
11/18/2021
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