Individual
ALEXANDRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 270-2174
Mailing address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 270-2174
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
21110475
CO
133V00000X
Registered Dietitian
993180
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008
INTERNSHIP CERTIFICATE DIETETICS
CO
01
—
21110475
CERTIFIED DIABETES EDUCATOR
CO
01
—
993180
REGISTERD DIETICIAN
CO
Enumeration date
03/26/2015
Last updated
03/26/2015
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