Susan B Clark, MS, RD, LD, CDE

NPI #1124676663 in Rexburg, Idaho

Provider Information

NPI Number: 1124676663
Entity Type: Individual
Name: Susan B Clark, MS, RD, LD, CDE
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Credential: MS, RD, LD, CDE
Enumeration Date: Aug 28, 2019
Last Updated: Nov 24, 2025

Practice Location

Address: 393 E 2ND N
City: Rexburg
State: Idaho
ZIP Code: 83440-1605
Phone: (208) 356-5401

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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