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General NPI Number Information
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NPI Number | 1538318266
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Entity Type | Individual
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Provider Name | KATHRYN MARGARET JOHNSON R.D., L.D.
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Gender | Female
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 1935 MOTOR STREET CLINICAL NUTRITION
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City | DALLAS
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State | TX
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Zip | 75235
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Country | US
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Telephone | 214-456-2178
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Fax | 214-456-6287
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Provider Business Mailing Address
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Address Line | 2626 REAGAN ST APT. 113
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City | DALLAS
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State | TX
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Zip | 75219-3312
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Country | US
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Telephone | 214-908-5234
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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 | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | DT80742
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License Number State | TX
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