Individual
ALISSA T MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
3202 W GOOD ST, BOISE, ID 83703-5546
(208) 999-6466
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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