Individual
DEIDRA LAUREN WOOD SISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
434 STAR HILL DR, CAPE CARTERET, NC 28584-9755
(252) 515-4415
Mailing address
514 E SACK DR, PHOENIX, AZ 85024-2217
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L004298
NC
Other
Enumeration date
05/12/2017
Last updated
01/08/2025
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