Individual
EMILY JANE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
4536 22ND AVE, KENOSHA, WI 53140-5917
(262) 646-0044
Mailing address
4536 22ND AVE, KENOSHA, WI 53140-5917
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001107993
WI
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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