Provider Demographics
NPI:1013315506
Name:MASON, EMILY SUSAN (RDN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUSAN
Last Name:MASON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6920 E. ROCKY CANYON PL.
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750
Mailing Address - Country:US
Mailing Address - Phone:520-730-3094
Mailing Address - Fax:520-428-5812
Practice Address - Street 1:2806 N. ALVERNON WAY, #500
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:520-730-3094
Practice Address - Fax:520-428-5812
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
687938133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered