Individual
STEFANIE LYNN WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSG, LD
Contact information
Practice address
770 DENNARD ST, LONGVIEW, TX 75605-8295
(903) 220-8685
(903) 663-8764
Mailing address
770 DENNARD ST, LONGVIEW, TX 75605-8295
(903) 220-8685
(903) 663-8764
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT04780
TX
Other
Enumeration date
04/12/2012
Last updated
04/12/2012
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