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Individual

MRS. ELISABETH J WARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., R.D., L.D.

Contact information

Practice address
1935 MOTOR ST, CLINICAL NUTRITION, DALLAS, TX 75235-7701
(214) 456-5062
(214) 456-6287
Mailing address
3009 BLUE JAY LN, MIDLOTHIAN, TX 76065-8705
(972) 775-2885

Taxonomy

Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT07400
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
913190
CDR LICENSURE
TX
Enumeration date
09/13/2006
Last updated
07/08/2007
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