Provider Demographics
NPI:1386226769
Name:FINAZZO, TERESA (RDN, LD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:FINAZZO
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 1:851 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5418
Mailing Address - Country:US
Mailing Address - Phone:197-246-7421
Mailing Address - Fax:972-462-0490
Practice Address - Street 1:851 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5418
Practice Address - Country:US
Practice Address - Phone:972-467-4214
Practice Address - Fax:972-462-0490
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-25
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85876133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered