NPI 1033497425

Lacey Waddell, MSRDLD

Practitioner Registered Dietitian Sundance, WY

Practice location

Address: 713 W Oak Street, Sundance, WY 82729
Phone: (307) 283-3501
Mailing address: PO Box 517, Sundance, WY 82729-0517

Registered specialties (2)

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 211 (WY)

Other Dietitian, Registered providers in Wyoming →

Registered Dietitian

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 0410 (SD)

Registry record

NPI: 1033497425
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Aug 2011
Record last updated: 20 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.