Individual
CANDACE MARIE HERZOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
4516 109TH ST, LUBBOCK, TX 79424-5792
(832) 465-5908
Mailing address
4516 109TH ST, LUBBOCK, TX 79424-5792
(832) 465-5908
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT07300
TX
133VN1004X
Pediatric Nutrition Registered Dietitian
DT07300
TX
Other
Enumeration date
03/31/2010
Last updated
03/31/2010
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