Doctor Name: | TARA MARIE DEWITT |
NPI Number: | 1255787271 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, RDN, LD |
License Number: | 3692 |
Business Practice Address: | 1130 Burch Ln University City, MO - 631302219 |
Business Phone Number: | 3208085353 |
Business Fax Number: | |
Mailing Address: | 1130 Burch Ln, UNIVERSITY CITY |
State: | MO |
Postal Code: | 631302219 |
Phone Number: | 3208085353 |
Fax Number: | |
NPI Enumeration Date: | 05/09/2016 |
NPI Last Update Date: | 05/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 3692 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |