Individual
HALEY FOLLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPAS, PA-C, RD, LD
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-2140
(817) 332-2506
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
DT83853
TX
363A00000X
Physician Assistant
Primary
PA16092
TX
363AM0700X
Medical Physician Assistant
PA16092
TX
Other
Enumeration date
01/05/2016
Last updated
06/19/2024
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