Individual
MIRANDA ANSPACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2909 N 4TH ST APT 16, COEUR D ALENE, ID 83815-6031
(208) 310-3136
Mailing address
2909 N 4TH ST APT 16, COEUR D ALENE, ID 83815-6031
(208) 310-3136
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1113
ID
Other
Enumeration date
12/13/2020
Last updated
06/13/2023
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