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Individual

BRANDIE MARIE WILDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
38232 KIRTLEY AVE, PRAIRIEVILLE, LA 70769-4267
(504) 401-0647
Mailing address
38232 KIRTLEY AVE, PRAIRIEVILLE, LA 70769-4267
(504) 401-0647

Taxonomy

Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
3004
LA

Other

Enumeration date
03/12/2021
Last updated
03/27/2026
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