Individual
AMBER IVIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDLD
Contact information
Practice address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 569-4300
Mailing address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 569-4300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84727
TX
Other
Enumeration date
06/01/2017
Last updated
07/21/2022
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