Individual
DENISE MICHELE WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNS, LDN
Contact information
Practice address
6 TIFFANY DR, REHOBOTH BEACH, DE 19971-9729
(302) 519-1840
Mailing address
6 TIFFANY DR, REHOBOTH BEACH, DE 19971-9729
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
DN-0010836
DE
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
DN-0010836
DE
Other
Enumeration date
12/17/2025
Last updated
12/17/2025
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