Provider Demographics
NPI:1366839979
Name:4TDD.COM, INC.
Entity Type:Organization
Organization Name:4TDD.COM, INC.
Other - Org Name:THE DELICIOUS DIETITIAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-767-7400
Mailing Address - Street 1:55 MIDTOWN PARK E
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4141
Mailing Address - Country:US
Mailing Address - Phone:251-767-7400
Mailing Address - Fax:251-478-2231
Practice Address - Street 1:55 MIDTOWN PARK E
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4141
Practice Address - Country:US
Practice Address - Phone:251-478-2233
Practice Address - Fax:251-478-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL076850302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization