Individual
MS. VIRGINIA IVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE, LPC
Contact information
Practice address
3144 TEX BLVD, FORT WORTH, TX 76116-4224
(214) 538-6565
Mailing address
3144 TEX BLVD, FORT WORTH, TX 76116-4224
(214) 538-6565
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
60632
TX
133V00000X
Registered Dietitian
DT02650
TX
133VN1006X
Metabolic Nutrition Registered Dietitian
DT02650
TX
207V00000X
Obstetrics & Gynecology Physician
Primary
DT02650
TX
Other
Enumeration date
05/01/2007
Last updated
12/27/2024
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