Individual
MRS. KENNETTE MONISA WILSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
17904 HASLEMERE LN, EDMOND, OK 73012-4575
(405) 315-4877
Mailing address
17904 HASLEMERE LN, EDMOND, OK 73012-4575
(405) 359-4877
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1033
OK
Other
Enumeration date
02/28/2008
Last updated
10/27/2020
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