Provider Demographics
NPI:1245836378
Name:SCHOMP, VICTORIA TALLEY (MS, RD, LD/N)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:TALLEY
Last Name:SCHOMP
Suffix:
Gender:F
Credentials:MS, RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7363 62ND AVE N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-4839
Mailing Address - Country:US
Mailing Address - Phone:727-458-2994
Mailing Address - Fax:
Practice Address - Street 1:501 6TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-2307
Practice Address - Country:US
Practice Address - Phone:727-767-8562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7270133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered