Individual
ELISE MICHELLE EDWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CDCES
Contact information
Practice address
5098 SW TECHNOLOGY LOOP APT 205, CORVALLIS, OR 97333-1591
(520) 286-0974
Mailing address
5098 SW TECHNOLOGY LOOP APT 205, CORVALLIS, OR 97333-1591
(520) 286-0974
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86090302
AZ
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
86090302
AZ
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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