Individual
MS. BONNIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. R.D.
Contact information
Practice address
125 LASALLE RD, WEST HARTFORD, CT 06107-2322
(860) 906-1289
Mailing address
125 LASALLE RD, WEST HARTFORD, CT 06107-2322
(860) 906-1289
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
000154
CT
133V00000X
Registered Dietitian
Primary
725073
CT
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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