Individual
STEPHANIE WIELOSINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(800) 360-8367
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/07/2025
Last updated
11/07/2025
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