Andrea Addley
Dietitian, Registered in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1013255066
StatusActive
Last updated in NPPESFeb 5, 2025
Details
- NPI
- 1013255066
- Entity type
- Individual (NPI-1)
- Name
- Andrea Addley
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 26, 2013
- Certification date
- Feb 5, 2025
- Last updated
- Feb 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 6511772-4901 | UT | Yes |
Practice location
1174 E Graystone Way Ste 1aSalt Lake City, UT 84106-2671
Phone 801-664-2182
Mailing address
715 Ranch Loop RdPreston, ID 83263-5116
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