Individual
AMY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
2800 CLAY EDWARDS DR, NORTH KANSAS CITY, MO 64116-3220
(816) 691-4142
Mailing address
2800 CLAY EDWARDS DR, NORTH KANSAS CITY, MO 64116-3220
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2001021459
MO
Other
Enumeration date
03/22/2011
Last updated
03/22/2011
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