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Individual
DR. STACIE VANESSA ELLIS
Active
Individual
DR. STACIE VANESSA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LD
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
DT83743
TX
133V00000X
Registered Dietitian
Primary
DT83743
TX
Other
Enumeration date
07/13/2015
Last updated
11/30/2023
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