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Individual
JULIA B SULLIVAN
Active
Individual
JULIA B SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, MPAS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
DT83553
TX
363A00000X
Physician Assistant
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86048739
REGISTERED DIETITIAN
—
01
—
DT83553
LICENSED DIETITIAN
TX
Enumeration date
03/23/2016
Last updated
08/20/2024
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