Provider Demographics
NPI:1497191126
Name:HOUSE, CIARA CSANADI (RD)
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:CSANADI
Last Name:HOUSE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CIARA
Other - Middle Name:DIANE
Other - Last Name:CSANADI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:10810 PARKSIDE DR STE 305
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1986
Mailing Address - Country:US
Mailing Address - Phone:865-392-3971
Mailing Address - Fax:865-392-3972
Practice Address - Street 1:10810 PARKSIDE DR STE 305
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1986
Practice Address - Country:US
Practice Address - Phone:865-392-3971
Practice Address - Fax:865-392-3972
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2389133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ048418Medicaid