Individual
MRS. STACEY S VAN ORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-7352
Mailing address
15814 HACHITA BLANCO, HELOTES, TX 78023-3756
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/04/2006
Last updated
06/23/2020
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