Doctor Name: | MRS. SHERALEE DAHLE PETERSEN |
NPI Number: | 1114110921 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C |
License Number: | 5190165-4901 |
Business Practice Address: | 5169 S Cottonwood St Ste 520 Murray, UT - 841076756 |
Business Phone Number: | 8015073500 |
Business Fax Number: | 8015073505 |
Mailing Address: | Po Box 27128, SALT LAKE CITY |
State: | UT |
Postal Code: | 841270128 |
Phone Number: | 8015073500 |
Fax Number: | 8015073505 |
NPI Enumeration Date: | 08/24/2007 |
NPI Last Update Date: | 06/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 5190165-4901 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |