Individual
MISS ILIANA GUERRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD.CSP.LD.
Contact information
Practice address
2302 E 28TH ST, MISSION, TX 78574-1910
(956) 458-6156
Mailing address
2302 E 28TH ST, MISSION, TX 78574-1910
(956) 458-6156
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT07323
TX
133VN1004X
Pediatric Nutrition Registered Dietitian
DT07323
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178789701
—
TX
Enumeration date
04/04/2007
Last updated
05/19/2011
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