Individual
MISS ALEXANDRA SHARAPOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CSO, CD
Contact information
Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 241-2102
Mailing address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 241-2102
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1930
WI
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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