Individual
CORBY WILFLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 ROCKMOOR AVE APT B, AUSTIN, TX 78703-2023
(512) 964-0345
Mailing address
1605 ROCKMOOR AVE APT B, AUSTIN, TX 78703-2023
(512) 964-0345
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT83819
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT83819
TDLR
TX
Enumeration date
10/22/2021
Last updated
10/22/2021
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