Individual
JOHANNA CUESTA ULLOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD, RD
Contact information
Practice address
1210 W BRAKER LN, AUSTIN, TX 78758-3801
(512) 978-9300
(512) 901-9737
Mailing address
1210 W BRAKER LN, AUSTIN, TX 78758-3801
(512) 978-9300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1101653
NV
133V00000X
Registered Dietitian
Primary
DT85850
TX
Other
Enumeration date
11/27/2012
Last updated
04/16/2019
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