Provider Demographics
NPI:1073988481
Name:FREIRICH, TANYA BETH (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:BETH
Last Name:FREIRICH
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 W KERR ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-3241
Mailing Address - Country:US
Mailing Address - Phone:704-640-1551
Mailing Address - Fax:
Practice Address - Street 1:815 W KERR ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3241
Practice Address - Country:US
Practice Address - Phone:704-640-1551
Practice Address - Fax:704-368-1840
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 133NN1002X
NY1093104133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education