| The Celiac Space, Llc | |
|
60 Four T Ranch Rd, Georgetown, TX 78633-4350 | |
| (949) 282-9928 | |
| Not Available |
| Full Name | The Celiac Space, Llc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 60 Four T Ranch Rd, Georgetown, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699312496 | NPI | - | NPPES |
| DT85889 | Other | TX | TEXAS LICENSED DIETITIAN |
| 86096130 | Other | ACADEMY OF NUTRITION AND DIETETICS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| The Celiac Space, Llc 60 Four T Ranch Rd, Georgetown, TX 78633-4350 Ph: (949) 282-9928 | The Celiac Space, Llc 60 Four T Ranch Rd, Georgetown, TX 78633-4350 Ph: (949) 282-9928 |
Hope Van Der Heijden, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1915 S Austin Ave, Suite 106, Georgetown, TX 78626 Phone: 512-948-7534 | |
Michelle Carter, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 204 Alyssa Dr, Georgetown, TX 78633 Phone: 512-541-7963 | |
Norma Sue Thyen, MS, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 31002 La Quinta Dr, Georgetown, TX 78628 Phone: 512-945-0632 | |
Carly Ann Wright, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2300 Wolf Ranch Pkwy Apt 5106, Georgetown, TX 78628 Phone: 512-484-8925 | |
Renegade Rd Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 909 Balsora Cv, Georgetown, TX 78628 Phone: 936-349-6546 | |
Nutrifabulous, Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1915 S Austin Ave, Ste 106, Georgetown, TX 78626 Phone: 512-948-7534 | |
Erin Kenny, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 60 Four T Ranch Rd, Georgetown, TX 78633 Phone: 949-282-9928 |