SAMANTHA WADE

BOISE, ID
NPI1891416889
Former NameSAMANTHA SHANAHAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: ID  D-1287)
Enumeration Date2022-09-07
Last Update Date2022-09-07
Business Address
SAMANTHA WADE RD
1910 UNIVERSITY DR
BOISE, ID 83725-0002
Phone number: 206-795-2335
Mailing Address
SAMANTHA WADE RD
1910 UNIVERSITY DR
BOISE, ID 83725-0002
Phone number: