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Individual

MRS. LAILINA S WISOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
6138 SPEARMINT CT, FORT COLLINS, CO 80528-7010
(303) 249-8061
(833) 806-0721
Mailing address
6714 73RD PL # 2, MIDDLE VILLAGE, NY 11379-2527
(303) 249-8061

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
011624-01
NY
133V00000X
Registered Dietitian
Primary
230-LD
HI
133V00000X
Registered Dietitian

Other

Enumeration date
03/07/2007
Last updated
07/08/2025
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