MRS. Tenisha D Tavares, RD

NPI #1740474352 in Canon City, Colorado

Provider Information

NPI Number: 1740474352
Entity Type: Individual
Name: MRS. Tenisha D Tavares, RD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dietitian, Registered
Credential: RD
Enumeration Date: Aug 28, 2007
Last Updated: Aug 28, 2007

Practice Location

Address: 1338 PHAY AVE
City: Canon City
State: Colorado
ZIP Code: 81212-2302
Phone: (719) 285-2025

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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