Individual
ALYSSA DOLORES FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
3724 JEFFERSON ST, SUITE 104, AUSTIN, TX 78731-6225
(512) 970-8658
Mailing address
1500 E RIVERSIDE DR APT 107, AUSTIN, TX 78741-1132
(512) 970-8658
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT82087
TX
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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