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Individual

GWENDOLYN ANN WITTENBROOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, RD, CSP, LD

Contact information

Practice address
12606 GREENVILLE AVE STE 200, DALLAS, TX 75243-1923
(469) 780-4590
(972) 437-1988
Mailing address
12606 GREENVILLE AVE STE 200, DALLAS, TX 75243-1923
(469) 780-4590
(972) 437-1988

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT05870
TX
133VN1004X
Pediatric Nutrition Registered Dietitian
DT05780
TX

Other

Enumeration date
07/16/2015
Last updated
11/19/2025
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