Individual
KELLY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
6865 HITCHINGHAM RD, YPSILANTI, MI 48197-8998
(248) 891-7195
Mailing address
6865 HITCHINGHAM RD, YPSILANTI, MI 48197-8998
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
MI
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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