Provider Demographics
NPI:1275304156
Name:TARA THE RD
Entity Type:Organization
Organization Name:TARA THE RD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:DEWITT
Authorized Official - Last Name:ZAUHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD, CSSD
Authorized Official - Phone:320-808-5353
Mailing Address - Street 1:8120 PENN AVE S STE 252
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1365
Mailing Address - Country:US
Mailing Address - Phone:320-808-5353
Mailing Address - Fax:
Practice Address - Street 1:12735 42ND PL N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-2350
Practice Address - Country:US
Practice Address - Phone:320-808-5353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty