Individual
KELLY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CDCES
Contact information
Practice address
200 N KIMBALL AVE STE 221, SOUTHLAKE, TX 76092-6660
(817) 518-7239
Mailing address
3035 WIND KNOT WAY, ROYSE CITY, TX 75189-0500
(214) 213-6217
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT81714
TX
Other
Enumeration date
01/18/2024
Last updated
08/28/2024
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