Provider Demographics
NPI:1568345502
Name:WALIA, CASSANDRA LYNN SOVA (MS, RD, CD)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN SOVA
Last Name:WALIA
Suffix:
Gender:F
Credentials:MS, RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 W CONNELL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3067
Mailing Address - Country:US
Mailing Address - Phone:414-266-4948
Mailing Address - Fax:
Practice Address - Street 1:3365 S 103RD ST STE 100
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4162
Practice Address - Country:US
Practice Address - Phone:414-266-4948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2251-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered