Individual
MRS. SHANNON ROSE WACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
2545 SCHOENERSVILLE RD, BETHLEHEM, PA 18017-7300
(516) 806-7758
Mailing address
4531 PARK VIEW DR APT R10, SCHNECKSVILLE, PA 18078-2555
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006977
PA
Other
Enumeration date
09/26/2021
Last updated
09/26/2021
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