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General NPI Number Information
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NPI Number | 1518589977
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Entity Type | Individual
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Provider Name | ANDREA BREE GRASSI MS, RD, LD, CDE
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Gender | Female
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 1600 11TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4300
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Country | US
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Telephone | 940-249-0285
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Fax |
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Provider Business Mailing Address
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Address Line | 7 AMBER VLY
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City | WICHITA FALLS
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State | TX
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Zip | 76308-1527
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Country | US
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Telephone | 940-249-0285
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number | DT82712
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License Number State | TX
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