Susan Elizabeth Wallace, R,D., L.D.

NPI #1376842732 in Lakeside Park, Kentucky

Provider Information

NPI Number
1376842732
Entity Type
Individual
Name
Susan Elizabeth Wallace, R,D., L.D.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dietitian, Registered
Credential
R,D., L.D.
Enumeration Date
Mar 23, 2011
Last Updated
Mar 23, 2011

Practice Location

Address
102 CARRAN DR
ZIP Code
41017-2233
Phone
(859) 331-2939

Specialties & Taxonomy Codes

Specialty
Dietitian, Registered

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