Alicia D Susilla, BS
NPI #1154315968 in Longview, Washington
Provider Information
- NPI Number
- 1154315968
- Entity Type
- Individual
- Name
- Alicia D Susilla, BS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dietitian, Registered
- Credential
- BS
- Enumeration Date
- Sep 7, 2005
- Last Updated
- Jul 9, 2007
Practice Location
- Address
- 600 BROADWAY ST
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-3256
- Phone
- (360) 414-2200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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