Individual
MRS. KIM HALI WOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN
Contact information
Practice address
285 E MAIN ST STE 105, SMITHTOWN, NY 11787-2912
(631) 509-0390
Mailing address
20 SWALLOW LN, HAUPPAUGE, NY 11788-2220
(631) 724-1575
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
008749
NY
Other
Enumeration date
06/29/2017
Last updated
06/29/2017
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