Individual
LYNN SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CSP, LD
Contact information
Practice address
919 E 32ND ST, FOOD & NUTRITION SERVICES, AUSTIN, TX 78705-2703
(512) 544-4041
Mailing address
919 E 32ND ST, FOOD & NUTRITION SERVICES, AUSTIN, TX 78705-2703
(512) 544-4041
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT80707
TX
133VN1004X
Pediatric Nutrition Registered Dietitian
952231
TX
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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