Individual
CARMALITA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
1400 8TH AVE, FT WORTH, TX 76104-4110
(817) 922-2034
Mailing address
7569 KINGS TRL, FT WORTH, TX 76133-8347
(225) 802-7743
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT87482
TX
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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