Individual
KATIE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
18839 MCKAY DR, HUMBLE, TX 77338-5721
(281) 446-3655
Mailing address
16624 LONELY PINES DR, CONROE, TX 77302-8315
(281) 728-4020
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT86206
TX
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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