Individual
GRACE ELIZABETH HENSOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
8940 N WOOD SAGE RD, PEORIA, IL 61615-7822
(309) 243-3464
Mailing address
8940 N WOOD SAGE RD, PEORIA, IL 61615-7822
(309) 243-3464
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007298
IL
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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