Individual
MRS. MICHELLE DENISE HOOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RD, LDN
Contact information
Practice address
3540 BLACK OAK LN, EDWARDSVILLE, IL 62025-7034
(618) 334-0402
(618) 659-3948
Mailing address
3540 BLACK OAK LN, EDWARDSVILLE, IL 62025-7034
(618) 334-0402
(618) 659-3948
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2001023440
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060811170911448
—
MO
Enumeration date
10/04/2006
Last updated
10/20/2008
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