Provider Demographics
NPI:1285827790
Name:TEUWEN, LINDA BRIDGET (RD, LD)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:BRIDGET
Last Name:TEUWEN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-1524
Mailing Address - Country:US
Mailing Address - Phone:508-385-9272
Mailing Address - Fax:617-414-4633
Practice Address - Street 1:41 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-1524
Practice Address - Country:US
Practice Address - Phone:508-385-9272
Practice Address - Fax:617-414-4633
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered