NPI 1154783199

Kyli Gough, RDNLD

Practitioner Registered Dietitian Twin Falls, ID

Practice location

Address: 496 Shoup Ave W STE a, Twin Falls, ID 83301-5043
Phone: (208) 814-9182
Mailing address: PO Box 599, Shoshone, ID 83352-0599

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence D-781 (ID)

Other Dietitian, Registered providers in Idaho →

Registry record

NPI: 1154783199
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Mar 2016
Record last updated: 28 Mar 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.