Individual
MS. JACQUELYN DORN CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,L.D.
Contact information
Practice address
522 E PIERCE ST, LULING, TX 78648-2613
(830) 351-0566
Mailing address
409 E JONES ST, LULING, TX 78648-1943
(830) 875-5507
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
DT01962
TX
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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