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Individual

JESSICA HOUDYSHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LD, CDE

Contact information

Practice address
29 NW 1ST LN, LAMAR, MO 64759-8105
(417) 681-5263
Mailing address
4202 S SERGEANT AVE, JOPLIN, MO 64804-4500
(417) 540-6729

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2004008859
MO

Other

Enumeration date
03/20/2007
Last updated
05/17/2013
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