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1104136845
LESLIE DEFOREST IVEY
AUSTIN, TX
NPI
1104136845
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: TX DT05853)
Enumeration Date
2010-10-15
Last Update Date
2010-10-15
Business Address
Mrs. LESLIE DEFOREST IVEY RD, LD
3000 N. IH35 SUITE #770
AUSTIN, TX 78705
Phone number: 512-482-8880
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Mailing Address
Mrs. LESLIE DEFOREST IVEY RD, LD
3000 N. IH35 SUITE #770
AUSTIN, TX 78705
Phone number: 512-482-8880
Copy
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