Individual
STEPHANIE MARIE VANDE BRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D
Contact information
Practice address
1914 8TH ST, CORALVILLE, IA 52241-1612
(319) 351-5523
Mailing address
1914 8TH ST, CORALVILLE, IA 52241-1612
(319) 351-5523
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
002142
IA
Other
Enumeration date
04/15/2014
Last updated
08/05/2014
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