Individual
LESLEY RAE LOVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3100 SUFFOLK DR, MANSFIELD, TX 76063-4060
(817) 453-9887
Mailing address
3100 SUFFOLK DR, MANSFIELD, TX 76063-4060
(817) 453-9887
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT04851
TX
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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