Individual
STACEY WALSEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
7785 N STATE ST, LOWVILLE, NY 13367-1229
(315) 376-5081
Mailing address
4669 ZECHER RD, CARTHAGE, NY 13619-6017
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
009548
NY
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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