Individual
MRS. MICHELLE ELAINE AGENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,R.D.
Contact information
Practice address
124 W THOMAS RD, PHOENIX, AZ 85013-4405
(602) 406-5822
Mailing address
124 W THOMAS RD, PHOENIX, AZ 85013-4405
(602) 406-5822
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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