Individual
MISS MARY ELIZABETH AGNEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
827 GULLETT ST, AUSTIN, TX 78702-4125
(512) 517-9156
Mailing address
827 GULLETT ST, AUSTIN, TX 78702-4125
(512) 517-9156
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
164.007313
IL
133V00000X
Registered Dietitian
Primary
DT84558
TX
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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