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Individual
MRS. GRETCHEN COLEMAN WALLACE
Active
Individual
MRS. GRETCHEN COLEMAN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
10235828
OR
133V00000X
Registered Dietitian
2023005984
MO
133V00000X
Registered Dietitian
Primary
DI60956654
WA
Other
Enumeration date
08/25/2017
Last updated
11/08/2023
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