Individual
KAITLIN WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-6353
Mailing address
5642 OSAGE LAKE DR APT 1B, MISHAWAKA, IN 46545-8451
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86084314
—
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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