Individual
MANDY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
415 S MESA HILLS DR APT 1142, EL PASO, TX 79912-5484
(915) 861-9119
Mailing address
415 S MESA HILLS DR APT 1142, EL PASO, TX 79912-5484
(915) 861-9119
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT86920
TX
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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