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Individual
WILDA FAYE WADE
Active
Individual
WILDA FAYE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.,RD, LDN
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001066
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14306
BLUE CROSS BLUE SHIELD
NC
Enumeration date
05/23/2007
Last updated
03/17/2008
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