Individual
KATIE GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCN, RD, LD
Contact information
Practice address
409 N BEACON ST, DALLAS, TX 75214-4702
(804) 317-8377
Mailing address
409 N BEACON ST, DALLAS, TX 75214-4702
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT83017
TX
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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