Individual
SHANNON BREELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 8TH AVE, FORT WORTH, TX 76104-3902
(817) 347-1980
Mailing address
900 8TH AVE, FORT WORTH, TX 76104-3902
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT85174
TX
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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