Individual
CINDY JEAN ANDREWS WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.N., M.B.A
Contact information
Practice address
3022 OLD MINDEN RD, BOSSIER CITY, LA 71112-2477
(318) 741-7314
(318) 741-7441
Mailing address
352 MERRITT RD, BENTON, LA 71006-4319
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
601842
LA
133V00000X
Registered Dietitian
Primary
601842
LA
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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