Provider Demographics
NPI:1740578137
Name:MCCUTCHIN, DAYNA RENAE (BASC, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:DAYNA
Middle Name:RENAE
Last Name:MCCUTCHIN
Suffix:
Gender:F
Credentials:BASC, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 9TH ST STE 260
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79415-5305
Mailing Address - Country:US
Mailing Address - Phone:806-744-8600
Mailing Address - Fax:806-744-0072
Practice Address - Street 1:3502 9TH ST STE 260
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-5305
Practice Address - Country:US
Practice Address - Phone:806-744-8600
Practice Address - Fax:806-744-0072
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82028133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered