Individual
LANIE BLAIR COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDLD
Contact information
Practice address
750 8TH AVE STE 200, FORT WORTH, TX 76104-2500
(682) 885-2170
(817) 335-8277
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DT81561
TX
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT81561
TX
Other
Enumeration date
07/01/2010
Last updated
05/11/2021
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