Most Relevant Information
Provider Data
| NPI Number: | 1003481854 |
| Provider Name: | MANDY JOHNSON MS, RD, LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | DT86920 |
Most Important Dates
| Enumeration Date: | 05/24/2021 |
| Last Updated: | 05/24/2021 |
Provider Practice Location
415 S MESA HILLS DR APT 1142
EL PASO
TX
799125484
Practice Location Phone/Fax
| Phone: | 9158619119 |
| Fax: |
Provider Mailing Location
415 S MESA HILLS DR APT 1142
EL PASO
TX
799125484
Provider Mailing Phone/Fax
| Phone: | 9158619119 |
| Fax: |