Individual
STEPHANIE ALYCE OLIVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T.R. , M.S.
Contact information
Practice address
14330 MIDWAY RD, STE 121, DALLAS, TX 75244-3522
(972) 930-0260
Mailing address
14330 MIDWAY RD, STE 121, DALLAS, TX 75244-3522
(972) 930-0260
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
136A00000X
Registered Dietetic Technician
Primary
—
—
Other
Enumeration date
04/04/2013
Last updated
04/04/2013
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