| Doctor Name: | CANDENCE A DIEFENDORF |
| NPI Number: | 1073730966 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD |
| License Number: | |
| Business Practice Address: | 1309 Sheldon Rd Grand Haven, MI - 494172404 |
| Business Phone Number: | 6168475547 |
| Business Fax Number: | |
| Mailing Address: | 17181 Ventura St, HOLLAND |
| State: | MI |
| Postal Code: | 494245639 |
| Phone Number: | 5856154654 |
| Fax Number: | |
| NPI Enumeration Date: | 04/20/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1005X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Renal |
| Taxonomy Definition: | |