Individual
MS. AMANDA GRACE CUMBERLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CNSD
Contact information
Practice address
800 W RANDOL MILL RD, CLINICAL NUTRITION, ARLINGTON, TX 76012-2504
(817) 548-6190
Mailing address
800 W RANDOL MILL RD, CLINICAL NUTRITION, ARLINGTON, TX 76012-2504
(817) 548-6190
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT07132
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
917942
REGISTERED DIETITIAN
TX
01
—
DT07132
LICENSED DIETITIAN
TX
Enumeration date
11/06/2007
Last updated
06/30/2008
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