Individual
KATIE ANNE KEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
621 N MAIN ST STE 250, GRAPEVINE, TX 76051-9213
(626) 898-3936
Mailing address
2317 GOLDENROD AVE, FORT WORTH, TX 76111-1612
(757) 650-0626
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86078349
TX
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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