Individual
ANASTASIA E MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S, R.D, L.D, CPT
Contact information
Practice address
1701 S LINCOLN AVE, SPRINGFIELD, IL 62704-3420
(217) 793-4367
Mailing address
1701 S LINCOLN AVE, SPRINGFIELD, IL 62704-3420
(217) 793-4367
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164001711
IL
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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