Individual
WILKA YANETH VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
1015 BOWLES AVE, FENTON, MO 63026-2394
(636) 496-2543
Mailing address
1058 TREETOP TRAIL DR, BALLWIN, MO 63021-7719
(636) 496-2543
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2014039270
MO
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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