Individual
JESSICA HOLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RD,LD
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-2500
(682) 885-2510
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT05224
TX
Other
Enumeration date
01/04/2016
Last updated
05/13/2021
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