Basic Information
| Provider Information | |||||||||
| NPI: | 1902435811 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOY | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3011 MELBOURNE CT E | ||||||||
| Address2: | |||||||||
| City: | MT JULIET | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371227540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103105007 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1607 S LOCUST AVE | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEBURG | ||||||||
| State: | TN | ||||||||
| PostalCode: | 384644011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9317626571 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2020 | ||||||||
| LastUpdateDate: | 04/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 3780 | TN | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.