Individual
JESSICA WILKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., LDN
Contact information
Practice address
2030 SE OCEAN BLVD, STUART, FL 34996-3304
(772) 626-4484
Mailing address
1862 SE MORNINGSIDE BLVD, PORT ST LUCIE, FL 34952-8818
(772) 626-4484
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
ND 6950
FL
133V00000X
Registered Dietitian
Primary
ND 6950
FL
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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