Individual
GINNY DACQUISTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
1134 LILY RD, OCONOMOWOC, WI 53066
(262) 443-1453
Mailing address
1134 LILY RD, OCONOMOWOC, WI 53066
(262) 443-1453
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86040888
WI
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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