Individual
MRS. KERRY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
265 N MAIN ST STE B, BOERNE, TX 78006-2044
(210) 415-0165
Mailing address
265 N MAIN ST STE B, BOERNE, TX 78006-2044
(210) 415-0165
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT04664
TX
Other
Enumeration date
06/29/2010
Last updated
03/11/2011
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