Provider Demographics
NPI:1114414075
Name:COTTO-MORENO, SONIA (RDN, LD)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:
Last Name:COTTO-MORENO
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7903 ANDREWS PASS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6085
Mailing Address - Country:US
Mailing Address - Phone:956-763-8256
Mailing Address - Fax:
Practice Address - Street 1:7903 ANDREWS PASS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-6085
Practice Address - Country:US
Practice Address - Phone:956-763-8256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05326133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered