Individual
NICHOLETTE SHAWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
9535 FOREST LN, DALLAS, TX 75243-5900
(817) 793-1670
Mailing address
1508 FLAMINGO DR, ARLINGTON, TX 76012-5513
(817) 793-1670
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84472
TX
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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