Provider Demographics
NPI:1033326608
Name:TORRES MARCO, OLYENKA DANIELA (RD, IBCLC)
Entity Type:Individual
Prefix:
First Name:OLYENKA
Middle Name:DANIELA
Last Name:TORRES MARCO
Suffix:
Gender:F
Credentials:RD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 FRANKLIN ST UNIT 2I
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-1738
Mailing Address - Country:US
Mailing Address - Phone:713-228-2885
Mailing Address - Fax:
Practice Address - Street 1:915 FRANKLIN ST UNIT 2I
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-1738
Practice Address - Country:US
Practice Address - Phone:713-228-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06904133V00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered174400000XOther Service ProvidersSpecialist