Individual
KIMBERLEY BROOKE WIEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN
Contact information
Practice address
12 MELLOW LN, WESTBURY, NY 11590-6325
(631) 921-2851
Mailing address
12 MELLOW LN, WESTBURY, NY 11590-6325
(631) 921-2851
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1012200
NY
Other
Enumeration date
06/10/2021
Last updated
08/27/2022
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