Individual
KAITLYN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
533 E COUNTY LINE RD STE 101, GREENWOOD, IN 46143-1074
(317) 957-9050
Mailing address
533 E COUNTY LINE RD STE 101, GREENWOOD, IN 46143-1074
(317) 957-9050
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37002417A
IN
Other
Enumeration date
08/18/2017
Last updated
08/18/2017
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