Individual
DARLA DANIEL O'DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
2606 N PECAN ST, NACOGDOCHES, TX 75965-3546
(936) 552-9901
Mailing address
2606 N PECAN ST, NACOGDOCHES, TX 75965-3546
(936) 552-9901
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
DT05074
TX
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
DT05074
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182303101
—
TX
Enumeration date
04/16/2007
Last updated
08/13/2014
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