Provider Demographics
NPI:1700596418
Name:DUFRESNE, CYNTHIA (RD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:DUFRESNE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 ORCHARD HILL DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-4742
Mailing Address - Country:US
Mailing Address - Phone:972-658-5530
Mailing Address - Fax:
Practice Address - Street 1:8405 ORCHARD HILL DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-4742
Practice Address - Country:US
Practice Address - Phone:972-658-5530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83981133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered