Individual
MS. KRISTINE L GODBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
7900 KERCHEVAL ST, DETROIT, MI 48214-2439
(313) 921-5500
Mailing address
13901 E JEFFERSON AVE, DETROIT, MI 48215-2720
(313) 921-5500
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
883716
MI
Other
Enumeration date
03/15/2012
Last updated
03/22/2012
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