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Individual

MS. GWENDOLYN ANN WREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CACDP

Contact information

Practice address
13336 E WARREN AVE, DETROIT, MI 48215-2112
(313) 822-6940
Mailing address
2459 PARKER ST, DETROIT, MI 48214-1824
(313) 743-2540

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
133N1002X
MI
133NN1002X
Nutrition Education Nutritionist

Other

Enumeration date
04/03/2012
Last updated
04/03/2012
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