Individual
STACY D PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D., L.D.
Contact information
Practice address
4810 N LOOP 289, LUBBOCK, TX 79416-3025
(806) 472-5325
(806) 687-7778
Mailing address
1805 79TH PL, LUBBOCK, TX 79423-2409
(806) 470-3489
(806) 687-7778
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT07584
TX
133V00000X
Registered Dietitian
LD0639
NM
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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