Individual
ABIGAIL LEIGH BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
706 TURTLE CREEK DR, TYLER, TX 75701-1833
(903) 595-3942
Mailing address
401 VZ COUNTY ROAD 2518, CANTON, TX 75103-3872
(903) 330-3970
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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