Provider Demographics
NPI:1003623984
Name:WILSON-TORRES, DEVON D (RDN)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:D
Last Name:WILSON-TORRES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1674 E MILKY WAY
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-5689
Mailing Address - Country:US
Mailing Address - Phone:480-329-8712
Mailing Address - Fax:
Practice Address - Street 1:1674 E MILKY WAY
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-5689
Practice Address - Country:US
Practice Address - Phone:480-329-8712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered