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Individual
MRS. SHANNON MOONEY WICKMAN
Active
Individual
MRS. SHANNON MOONEY WICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN, CSOWM
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2439
MA
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
DI1082
ME
Other
Enumeration date
10/20/2006
Last updated
07/24/2023
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