Provider Demographics
NPI:1679921811
Name:CHRISTENSEN, ALECIA (RD)
Entity type:Individual
Prefix:
First Name:ALECIA
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-3056
Mailing Address - Country:US
Mailing Address - Phone:435-512-8612
Mailing Address - Fax:385-244-4022
Practice Address - Street 1:40 W 1250 NORTH SUITE 8A
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341
Practice Address - Country:US
Practice Address - Phone:385-244-4020
Practice Address - Fax:385-244-4022
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered