Individual
MRS. CAROLINE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2624 WILLING AVE, FORT WORTH, TX 76110-3032
(281) 513-1602
Mailing address
2624 WILLING AVE, FORT WORTH, TX 76110-3032
(281) 513-1602
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT80593
TX
Other
Enumeration date
09/01/2010
Last updated
10/19/2023
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