Provider Demographics
NPI:1295412096
Name:DE FRANCO, LIBBY (BS NUTRITION)
Entity type:Individual
Prefix:MRS
First Name:LIBBY
Middle Name:
Last Name:DE FRANCO
Suffix:
Gender:F
Credentials:BS NUTRITION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 SUMMIT VW APT 4
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-3378
Mailing Address - Country:US
Mailing Address - Phone:661-868-9926
Mailing Address - Fax:
Practice Address - Street 1:1711 SUMMIT VW APT 4
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-3378
Practice Address - Country:US
Practice Address - Phone:661-868-9926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171400000X
171M00000X, 174H00000X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator