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Contact Information

ANNETTE K ANDERSON, MS, RD, LD, LMT
2100 N STATE HIGHWAY 360
SUITE 1106A
GRAND PRAIRIE, TX75050-1011
 Phone: 817-899-5450
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Massage Therapist

225700000X
Indicates primary specialty

NPI Profile & details for ANNETTE K ANDERSON · (Female)

NPI Number 1174828206
Status Active
Credentials MS, RD, LD, LMT
Entity Individual
Enumeration date 01/20/2011
Last updated 01/20/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # DT4158
  • TX License # MT40972
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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