NPI 1225423262 · live from the CMS NPI Registry
Serena Arave, RD, CNSC, LD
Dietitian, Registered, Nutrition, Pediatric in Boise, ID. National Provider Identifier 1225423262, active.
NPI record
| NPI | 1225423262 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered, Nutrition, Pediatric 133VN1004X |
| Practice location | 267 E Old Saybrook Dr, Boise, ID 83706 |
| Practice phone | 208-342-7198 |
| Enumerated | April 6, 2015 |
| Last updated | April 6, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Pediatric primary | 133VN1004X | D-414 (ID) |
| Dietitian, Registered, Nutrition, Metabolic | 133VN1006X | D-414 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.