Individual
AMANDA MICHELLE MCGINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
105 KATHRYN DR STE D, LEWISVILLE, TX 75067-4200
(800) 972-0643
(214) 279-5032
Mailing address
4251 FM 2181 STE 230-517, CORINTH, TX 76210-4219
(800) 972-0643
(214) 279-5032
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT06091
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT06091
STATE LICENSE
TX
Enumeration date
05/17/2022
Last updated
05/17/2022
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