Individual
ELISABETH HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RD,CSP,LD,CNSC
Contact information
Practice address
1935 MOTOR ST, CLINICAL NUTRITION, DALLAS, TX 75235-7701
(214) 456-7998
Mailing address
1012 SAN JACINTO DR, APT #1114, IRVING, TX 75063-8221
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT06970
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
925826
CDR - REGISTERED DIETITIA
TX
Enumeration date
09/13/2006
Last updated
07/30/2019
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