Individual
CHARLOTTE LORRAINE LIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2000 N JEFFERSON AVE, MT PLEASANT, TX 75455-2337
(903) 577-6198
(903) 577-6445
Mailing address
2000 N JEFFERSON AVE, MT PLEASANT, TX 75455-2337
(903) 577-6198
(903) 577-6445
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
806373
SC
Other
Enumeration date
03/16/2007
Last updated
01/08/2014
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