Individual
MIA EIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
6124 E BROWN RD STE 102, MESA, AZ 85205-4959
(480) 809-6513
(480) 809-6823
Mailing address
1301 N SCOTTSDALE RD APT 1053, SCOTTSDALE, AZ 85257-3457
(320) 212-4222
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86418972
AZ
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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