Individual
BRIANNA KAY WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
19805 S LA GRANGE RD, MOKENA, IL 60448-8348
(708) 938-3378
Mailing address
629 W DEMING PL, CHICAGO, IL 60614-2693
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007804
IL
Other
Enumeration date
01/23/2021
Last updated
01/23/2021
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