Provider Demographics
NPI:1144587783
Name:MINBIOLE, ANNE M (RD)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:M
Last Name:MINBIOLE
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 1:700 E BIG BEAVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1435
Mailing Address - Country:US
Mailing Address - Phone:248-244-2213
Mailing Address - Fax:248-275-5558
Practice Address - Street 1:700 E BIG BEAVER RD STE B
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1435
Practice Address - Country:US
Practice Address - Phone:248-244-2213
Practice Address - Fax:248-275-5558
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered