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Individual

EMILY WALLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
315 OAKWOOD ST, ROME, NY 13440-3806
(315) 525-3134
Mailing address
315 OAKWOOD ST, ROME, NY 13440-3806
(315) 525-3134

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary

Other

Enumeration date
12/05/2019
Last updated
12/05/2019
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