Provider Demographics
NPI:1609053172
Name:VOSS, EMILY DEJONG (RD)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:DEJONG
Last Name:VOSS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9051 WINDING RIVER DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76118-7756
Mailing Address - Country:US
Mailing Address - Phone:214-784-9244
Mailing Address - Fax:325-657-5453
Practice Address - Street 1:9051 WINDING RIVER DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76118-7756
Practice Address - Country:US
Practice Address - Phone:214-784-9244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
TXDT80618133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered