Provider Demographics
NPI:1346613601
Name:SMITH, EMILY FAYE (RDN, CSP, LD)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:FAYE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RDN, CSP, LD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:FAYE
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, CSP, LD
Mailing Address - Street 1:3301 SWISS CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6229
Mailing Address - Country:US
Mailing Address - Phone:214-820-6473
Mailing Address - Fax:
Practice Address - Street 1:3301 SWISS CIR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6229
Practice Address - Country:US
Practice Address - Phone:214-820-6473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82603133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric