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Individual

MS. DETRIA LATASHA BRANCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RDN, RHNC

Contact information

Practice address
10208 BON AIRE DR, EL PASO, TX 79924-2936
(888) 474-4486
(915) 301-9251
Mailing address
10208 BON AIRE DR, EL PASO, TX 79924-2936
(505) 417-0036
(915) 301-9251

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
133N00000X
Nutritionist
133NN1002X
Nutrition Education Nutritionist
133V00000X
Registered Dietitian
Primary
DT88116
TX
133V00000X
Registered Dietitian
LD2023085
NM
174H00000X
Health Educator
261QG0250X
Genetics Clinic/Center
261QH0100X
Health Service Clinic/Center

Other

Enumeration date
06/10/2020
Last updated
06/11/2023
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