Individual
MARYIA NASSONOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5740 AIRPORT FWY, HALTOM CITY, TX 76117-6005
(817) 258-6471
Mailing address
721 BANDIT TRL, KELLER, TX 76248-0111
(817) 723-9154
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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