Individual
HEIDI JILL WISNIOSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RD, LD
Contact information
Practice address
1290 RUNNING DEER DR, AUBURN, PA 17922-9267
(239) 314-6501
Mailing address
1290 RUNNING DEER DR, AUBURN, PA 17922-9267
(239) 314-6501
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006457
PA
Other
Enumeration date
10/06/2014
Last updated
09/18/2025
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