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Individual

PATRICIA SEVERSON-WAGER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RD, CDN, CDE

Contact information

Practice address
1365 WASHINGTON AVE, STE 300, ALBANY, NY 12206-1098
(518) 489-4704
(518) 489-0512
Mailing address
1365 WASHINGTON AVE, STE 300, ALBANY, NY 12206-1098
(518) 489-4704
(518) 489-0512

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
002617
NY

Other

Enumeration date
06/01/2005
Last updated
07/08/2007
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