Doctor Name: | TOMOKO OKADA |
NPI Number: | 1194011726 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, RD, CNSC, CDN |
License Number: | 006498-1 |
Business Practice Address: | 1451 Ridgetree Trails Dr Wildwood, MO - 630215944 |
Business Phone Number: | 9175662151 |
Business Fax Number: | |
Mailing Address: | 1451 Ridgetree Trails Dr, WILDWOOD |
State: | MO |
Postal Code: | 630215944 |
Phone Number: | 9175662151 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2011 |
NPI Last Update Date: | 02/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133VN1006X |
License Number: | 006498-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | Nutrition, Metabolic |
Taxonomy Definition: |