Individual
SUSAN K DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, RDN
Contact information
Practice address
13158 HAWKS BAY RD, DONNELLY, ID 83615-5503
(720) 490-9649
Mailing address
PO BOX 866, DONNELLY, ID 83615-0866
(720) 490-9649
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
803604
ID
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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