Individual
AMY R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
525 PLUM ST, SYRACUSE, NY 13204-1550
(862) 268-1765
Mailing address
525 PLUM ST, SYRACUSE, NY 13204-1550
(862) 268-1765
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00765401
NY
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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