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Individual

MARY ANN FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD LD

Contact information

Practice address
415 SPRINGTREE RD, LAKE DALLAS, TX 75065-2392
(214) 725-9702
Mailing address
415 SPRINGTREE RD, LAKE DALLAS, TX 75065-2392
(214) 725-9702

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT05158
TX

Other

Enumeration date
06/25/2007
Last updated
08/04/2015
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