Individual
SELENA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11801 SOUTH FWY, BURLESON, TX 76028-7021
(817) 551-2706
Mailing address
11801 S. FREEWAY, FORT WORTH, TX 76115
(817) 551-2706
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/28/2022
Last updated
06/13/2022
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