Individual
JOELLEN JUSTINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1001 E OREGON RD, LITITZ, PA 17543-9205
(717) 569-3271
Mailing address
25 S FORK PL, NEW PROVIDENCE, PA 17560-9778
(484) 888-6036
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004054
PA
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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