Individual
MARLA SUZANNE LANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
900 8TH AVE, FORT WORTH, TX 76104-3902
(817) 347-1982
Mailing address
10951 STONE CANYON RD APT 373, DALLAS, TX 75230-4347
(603) 856-6928
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84412
TX
Other
Enumeration date
07/04/2017
Last updated
07/04/2017
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