Individual
THERESA SUZANNE BOULDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CSG
Contact information
Practice address
3601 S 6TH AVE, MAIL CODE 0-002A1, TUCSON, AZ 85723-0001
(520) 792-1450
Mailing address
3601 S 6TH AVE, MAIL CODE 0-002A1, TUCSON, AZ 85723-0001
(520) 792-1450
(520) 518-5620
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/30/2012
Last updated
12/16/2014
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