Individual
MRS. MARY L HALLIBURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN,CSR, LD
Contact information
Practice address
4741 JOEL DRIVE, APT 33, EL PASO, TX 79924
(915) 490-1718
(915) 307-8678
Mailing address
4741 JOEL DR APT 33, EL PASO, TX 79924-6968
(915) 490-1718
(915) 307-8678
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
DT81903
TX
133VN1006X
Metabolic Nutrition Registered Dietitian
DT81903
TX
Other
Enumeration date
02/06/2013
Last updated
02/13/2014
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