Provider Demographics
NPI:1396085775
Name:MUCH, DIANE NEVILLE (MS, RD)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:NEVILLE
Last Name:MUCH
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E THUNDERBIRD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5306
Mailing Address - Country:US
Mailing Address - Phone:602-866-1220
Mailing Address - Fax:602-866-1288
Practice Address - Street 1:750 E THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5306
Practice Address - Country:US
Practice Address - Phone:602-866-1220
Practice Address - Fax:602-866-1288
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered