-- STEPHANIE LYNN HENDERSON -- RD LD
Individual Provider (NPI-1)
Active
Dietitian, Registered
Provider Information
- NPI Number
1528373313- Provider Type
- Individual Provider (NPI-1)
- Credentials
- RD LD
- Status
- Active
Contact & Location
- Address
- 1555 VERNON AVE, BLACKFOOT, ID, 83221
- Phone
- (307) 399-0139
Specialties & Taxonomies
Dietitian, Registered
Primary License: ID #D-629