Provider Demographics
NPI:1558089573
Name:CHO, JUDY M (BCHN, FNTP)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:M
Last Name:CHO
Suffix:
Gender:F
Credentials:BCHN, FNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 JOLLYVILLE RD UNIT 200782
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78720-5033
Mailing Address - Country:US
Mailing Address - Phone:512-522-2136
Mailing Address - Fax:
Practice Address - Street 1:11801 DOMAIN BLVD FL 3
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-3430
Practice Address - Country:US
Practice Address - Phone:512-522-2136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness Coach
No174200000XOther Service ProvidersMeals
No174H00000XOther Service ProvidersHealth Educator