Melissa Anne Smith
Nutritionist in Champaign, IL. Individual provider (NPI-1).
NPI number1164073979
StatusActive
Last updated in NPPESSep 23, 2019
Details
- NPI
- 1164073979
- Entity type
- Individual (NPI-1)
- Name
- Melissa Anne Smith
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 23, 2019
- Last updated
- Sep 23, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133N00000X | Nutritionist | 164004906 | IL | Yes |
Practice location
2501 Fields South DrChampaign, IL 61822-3733
Phone 217-239-2713 · Fax 217-356-7964
Mailing address
2501 Fields South DrChampaign, IL 61822-3733
Phone 217-239-2713 · Fax 217-356-7964
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