Individual
MIRANDA LEEANNA ALLMAN CONOVALOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
737 ADMIRALTY WAY, FORT WORTH, TX 76108-4002
(512) 635-7213
Mailing address
737 ADMIRALTY WAY, FORT WORTH, TX 76108-4002
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT85525
TX
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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