Individual
WILDA FAYE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.,RD, LDN
Contact information
Practice address
2007 YANCEYVILLE ST # 91, SUITE 407, GREENSBORO, NC 27405-5000
(336) 542-5545
Mailing address
2007 YANCEYVILLE ST # 91, SUITE 407, GREENSBORO, NC 27405-5000
(336) 339-2748
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001066
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14306
BLUE CROSS BLUE SHIELD
NC
Enumeration date
05/23/2007
Last updated
03/17/2008
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