Individual
KATHERINE WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
5010 LAKE MIST DR SE, MABLETON, GA 30126-5980
(404) 272-3142
(770) 818-1624
Mailing address
5010 LAKE MIST DR SE, MABLETON, GA 30126-5980
(404) 272-3142
(770) 818-1624
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002938
GA
Other
Enumeration date
05/13/2010
Last updated
05/13/2010
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