Provider Demographics
NPI:1962825869
Name:GARRETT, THERESA (RD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:SCHWEITZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16884 W MARSHALL LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-1527
Mailing Address - Country:US
Mailing Address - Phone:623-832-9309
Mailing Address - Fax:623-832-9356
Practice Address - Street 1:14719 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7203
Practice Address - Country:US
Practice Address - Phone:623-832-9309
Practice Address - Fax:623-832-9356
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered