Individual
DEANNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
1845 S DOBSON RD, SUITE 213, MESA, AZ 85202-5661
(602) 418-0646
Mailing address
1845 S DOBSON RD, SUITE 213, MESA, AZ 85202-5661
(602) 418-0646
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
944866
AZ
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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