Individual
MS. SHELLY RENEE WILDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CD
Contact information
Practice address
1700 W STOUT ST, RICE LAKE, WI 54868-5000
(715) 236-6139
Mailing address
1700 W STOUT ST, RICE LAKE, WI 54868-5000
(715) 236-6139
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00965973
WI
Other
Enumeration date
01/20/2011
Last updated
07/21/2022
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