Individual
RICHELLE SMITH-WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
1608 PLAZA DR, MARRERO, LA 70072-3344
(504) 352-7297
Mailing address
1608 PLAZA DR, MARRERO, LA 70072-3344
(504) 352-7297
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1722278
LA
133V00000X
Registered Dietitian
1722279
LA
171400000X
Health & Wellness Coach
1722277
LA
174200000X
Meals Provider
1722278
LA
174H00000X
Health Educator
172277
LA
225700000X
Massage Therapist
1722277
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
LA
Enumeration date
08/05/2021
Last updated
08/05/2021
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