Individual
MARIE ELIZABETH GROVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CNSC, LD
Contact information
Practice address
17111 PRESTON RD, SUITE 100, DALLAS, TX 75248-1229
(972) 754-7498
(210) 519-3000
Mailing address
668 BRYN MAHR LN, ROCKWALL, TX 75087-6018
(972) 754-7498
(972) 722-1242
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT07645
TX
133VN1004X
Pediatric Nutrition Registered Dietitian
DT07645
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
895816
REGISTERD DIETIITIAN
—
01
—
DT07645
LICENSED DIETITIAN
TX
Enumeration date
08/29/2007
Last updated
03/31/2014
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