Provider Demographics
NPI:1609952795
Name:LYNCH, CHERRI MARISA (MS, RD/LD, CFCS)
Entity Type:Individual
Prefix:MRS
First Name:CHERRI
Middle Name:MARISA
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MS, RD/LD, CFCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 RIMROCK TRL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-2814
Mailing Address - Country:US
Mailing Address - Phone:972-365-8071
Mailing Address - Fax:972-468-1445
Practice Address - Street 1:4111 W CAMP WISDOM RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2422
Practice Address - Country:US
Practice Address - Phone:972-709-0212
Practice Address - Fax:781-314-0206
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80206133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered