Individual
MRS. DORIS FIORILLO WICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN, CNSC
Contact information
Practice address
19220 MAKAYLA LN, CORNELIUS, NC 28031-6527
(772) 633-3176
Mailing address
19220 MAKAYLA LN, CORNELIUS, NC 28031-6527
(772) 633-3176
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
L003291
NC
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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