Individual
HALEY NICHOLE GOODFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
60 S STATE ROUTE 157, EDWARDSVILLE, IL 62025-3846
(618) 655-8147
Mailing address
213 LONGVIEW DR, COLUMBIA, IL 62236-2079
(618) 531-6029
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164008029
IL
133V00000X
Registered Dietitian
2020013164
MO
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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