Stephanie Lynn Henderson, RD LD

NPI #1528373313 in Blackfoot, Idaho

Provider Information

NPI Number
1528373313
Entity Type
Individual
Name
Stephanie Lynn Henderson, RD LD
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dietitian, Registered
Credential
RD LD
Enumeration Date
Aug 17, 2010
Last Updated
Jul 7, 2011

Practice Location

Address
1555 VERNON AVE
State
Idaho
ZIP Code
83221
Phone
(307) 399-0139

Specialties & Taxonomy Codes

Specialty
Dietitian, Registered

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