Individual
MRS. CASSANDRA MAE VANDERWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,R.D.,C.P.T.
Contact information
Practice address
600 HIGHLAND AVE, F4/120, MADISON, WI 53792-1510
(847) 707-6145
Mailing address
600 HIGHLAND AVE, F4/120, MADISON, WI 53792-1510
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
164005116
IL
133V00000X
Registered Dietitian
Primary
2508-29
WI
Other
Enumeration date
03/31/2010
Last updated
06/27/2012
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