Stacy L Wallace, RD Valid NPI

Individual provider · Metabolic Nutrition Registered Dietitian · San Antonio, TX

NPI

1487896668

Type

Individual (Type 1)

Primary specialty

Metabolic Nutrition Registered Dietitian (Dietitian, Registered)

Specialty group

Dietary & Nutritional Service Providers

Taxonomy code

133VN1006X

License number

855077 (TX)

Sex

Female

Sole proprietor

No

Enumerated

2009-04-02

Last updated

2009-04-02