Individual
MRS. WAHNETA M HAYWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D
Contact information
Practice address
312 9TH ST SW, WAVERLY, IA 50677-2929
(319) 352-4120
Mailing address
2722 BADGER AVE, JANESVILLE, IA 50647-9774
(319) 987-2345
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00150
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00150
LICENSE, DIETETICS
IA
01
—
401087
REGISTERED DIETITIAN
—
Enumeration date
01/13/2012
Last updated
01/13/2012
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