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Individual

MRS. CANDICE LYN WASOLASKUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.D.

Contact information

Practice address
1103 WEST SHERMAN AVENUE, BUILDING 2 UNIT C, VINELAND, NJ 08360
(856) 362-5259
(856) 407-6978
Mailing address
1103 WEST SHERMAN AVENUE, BUILDING 2 UNIT C, VINELAND, NJ 08360
(856) 362-5259
(856) 407-6978

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1036618
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60166181
HORIZON NJ HEALTH
NJ
Enumeration date
09/16/2013
Last updated
11/03/2016
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