Individual
DIANA KAHENDA KALULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2345 OLD PECOS TRL, FORT WORTH, TX 76131-1646
(774) 303-6267
Mailing address
2345 OLD PECOS TRL, FORT WORTH, TX 76131-1646
(774) 303-6267
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
322199
TX
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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