Provider Demographics
NPI:1518733641
Name:WILLIAMSON, ERIC (RD, PHD, CSSD, CSCS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:RD, PHD, CSSD, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7990 E SNYDER RD APT 9106
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-9018
Mailing Address - Country:US
Mailing Address - Phone:647-381-9220
Mailing Address - Fax:
Practice Address - Street 1:7990 E SNYDER RD APT 9106
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-9018
Practice Address - Country:US
Practice Address - Phone:647-381-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86242620133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered