Individual
WENDY M BACKAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
711 W ADAMS ST, BLACK RIVER FALLS, WI 54615-5052
(715) 284-5361
Mailing address
711 W ADAMS ST, BLACK RIVER FALLS, WI 54615-5052
(715) 284-5361
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3663-29
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86118957
CDR CERTIFICATION
WI
Enumeration date
10/21/2020
Last updated
02/28/2023
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