Individual
SUSANNE D WAKERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LDN
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7253
(508) 941-6337
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7885
(508) 941-6337
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
3059
MA
Other
Enumeration date
07/11/2011
Last updated
07/11/2011
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