Individual
SUSAN KAY CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D. L.D.
Contact information
Practice address
300 W ROSEDALE ST, FT WORTH, TX 76104-4856
(817) 882-6045
(817) 882-6595
Mailing address
1414 NEW HAVEN DR, MANSFIELD, TX 76063-3373
(817) 473-2170
(817) 882-6595
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT02735
TX
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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