Individual
MEGAN PAIGE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., RD
Contact information
Practice address
6060 DILBECK LANE, DALLAS, TX 75240
(972) 233-4444
Mailing address
6060 DILBECK LANE, DALLAS, TX 75240
(972) 233-4444
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1016858
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016858
COMMISION ON DIETETIC REGISTRATION
—
Enumeration date
09/13/2012
Last updated
09/13/2012
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