Healthcare Provider Details

I. General information

NPI: 1205384856
Provider Name (Legal Business Name): ERIN TALZZIA R.D.N., L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 12/21/2021
Certification Date: 12/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ
DAYTON OH
45404-1873
US

IV. Provider business mailing address

1 CHILDRENS PLZ
DAYTON OH
45404-1815
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3000
  • Fax:
Mailing address:
  • Phone: 937-641-3210
  • Fax: 937-641-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164.006892
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.08404
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: