| Doctor Name: | THERESA SUZANNE BOULDIN |
| NPI Number: | 1871869016 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD, CSG |
| License Number: | |
| Business Practice Address: | 3601 S 6th Ave Mail Code 0-002a1 Tucson, AZ - 857230001 |
| Business Phone Number: | 5207921450 |
| Business Fax Number: | |
| Mailing Address: | 3601 S 6th Ave, Mail Code 0-002a1 TUCSON |
| State: | AZ |
| Postal Code: | 857230001 |
| Phone Number: | 5207921450 |
| Fax Number: | 5205185620 |
| NPI Enumeration Date: | 03/30/2012 |
| NPI Last Update Date: | 12/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |