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Individual

ELLIE LIVINGSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, LD

Contact information

Practice address
8520 HAWKS NEST DR, FORT WORTH, TX 76131-5330
(205) 454-9899
Mailing address
8520 HAWKS NEST DR, FORT WORTH, TX 76131-5330
(205) 454-9899

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2021038779
MO
133V00000X
Registered Dietitian
3348
AL
133V00000X
Registered Dietitian
4129
TN
133V00000X
Registered Dietitian
Primary
DT86715
TX
133V00000X
Registered Dietitian
LD005975
GA
133V00000X
Registered Dietitian
ND10909
FL

Other

Enumeration date
01/11/2022
Last updated
01/11/2022
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