Individual
CARMEN ANN MORELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 S MEDFORD DR, LUFKIN, TX 75901-5633
(936) 693-1141
Mailing address
4101 S MEDFORD DR, LUFKIN, TX 75901-5633
(936) 693-1141
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT06862
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT06862
LICENSE #
TX
Enumeration date
01/25/2008
Last updated
01/25/2008
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