Individual
THERESA CHURILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1335 LEE STREET, WEST COMPLEX 5TH FLOOR, CHARLOTTESVILLE, VA 22911
(434) 924-9490
Mailing address
104 LUPINE LN, CHARLOTTESVILLE, VA 22911-9023
(434) 906-3034
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
133VN1005X
Renal Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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