Individual
ELLI KMIEC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1906 NEWNING AVE, AUSTIN, TX 78704-4338
(856) 535-1238
Mailing address
1906 NEWNING AVE, AUSTIN, TX 78704-4338
(856) 535-1238
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86100516
—
Other
Enumeration date
03/19/2020
Last updated
03/07/2024
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