Doctor Name: | MICHELLE DEITSCH |
NPI Number: | 1174955314 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD LN |
License Number: | 26754 |
Business Practice Address: | 535 Landmark Dr Belgrade, MT - 597147200 |
Business Phone Number: | 4065790809 |
Business Fax Number: | |
Mailing Address: | 535 Landmark Dr, BELGRADE |
State: | MT |
Postal Code: | 597147200 |
Phone Number: | 4065790809 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2013 |
NPI Last Update Date: | 07/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133NN1002X |
License Number: | 26754 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Nutritionist |
Taxonomy Specialization: | Nutrition, Education |
Taxonomy Definition: |