Anick Diessongo
NPI #1780463059 in Scott Air Force Base, Illinois
Provider Information
- NPI Number
- 1780463059
- Entity Type
- Individual
- Name
- Anick Diessongo
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dietitian, Registered
- Enumeration Date
- Sep 26, 2023
- Last Updated
- Sep 26, 2023
Practice Location
- Address
- 4711 THOMAS JEFFERSON CIR APT A
- State
- Illinois
- ZIP Code
- 62225-6225
- Phone
- (646) 288-5143
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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