Individual
MRS. TANIA CYNARA DE SOUSA BEZERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
310 HOME BLVD, GALESBURG, IL 61401-7408
(309) 343-0311
Mailing address
310 HOME BLVD, GALESBURG, IL 61401-7408
(309) 343-0311
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164006374
IL
133V00000X
Registered Dietitian
9034685-4901
UT
133V00000X
Registered Dietitian
DN005188
PA
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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