Individual
MS. LISA ANNE WINGHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPA, RDN
Contact information
Practice address
150 N 18TH AVE, PHOENIX, AZ 85007-3232
(585) 355-3265
Mailing address
150 N 18TH AVE, PHOENIX, AZ 85007-3232
(585) 355-3265
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
007022
NY
133V00000X
Registered Dietitian
Primary
00946879
NY
Other
Enumeration date
10/21/2010
Last updated
01/29/2021
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