Individual
ALESSA WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5121 S COTTONWOOD ST, SALT LAKE CITY, UT 84107-5701
(801) 232-6573
Mailing address
5121 S COTTONWOOD ST, SALT LAKE CITY, UT 84107-5701
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
9113041-4901
UT
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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