Individual
SELICIA MAYRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, RDN
Contact information
Practice address
3724 JEFFERSON ST STE 104, AUSTIN, TX 78731-6204
(480) 326-4591
Mailing address
3724 JEFFERSON ST STE 104, AUSTIN, TX 78731-6204
(480) 326-4591
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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