Individual
MARY TRAHAN LIVELY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LDN, RD
Contact information
Practice address
365 HIGHWAY 609, DELHI, LA 71232-6563
(318) 878-6760
Mailing address
309 JACKSON ST, MONROE, LA 71201-7407
(318) 327-4973
(318) 327-4975
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
858
LA
Other
Enumeration date
09/16/2005
Last updated
07/08/2007
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