Individual
MRS. MILLICENT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1002 LAUREL CV, BUDA, TX 78610-2872
(936) 615-8355
Mailing address
1002 LAUREL CV, BUDA, TX 78610-2872
(936) 615-8355
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT83426
TX
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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