Individual
MRS. JERILYN MARIE WASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LRD
Contact information
Practice address
6827 88TH AVE NE, STARKWEATHER, ND 58377-9330
(701) 292-4163
Mailing address
6827 88TH AVE NE, STARKWEATHER, ND 58377-9330
(701) 292-4163
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
630
ND
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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