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General NPI Number Information
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NPI Number | 1649553041
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Entity Type | Individual
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Provider Name | TERESIA F. HUDDLESTON MSRD, LD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 2625 SCOTTSVILLE RD
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City | BOWLING GREEN
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State | KY
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Zip | 42104-4477
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Country | US
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Telephone | 270-745-0942
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Fax | 270-745-0683
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Provider Business Mailing Address
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Address Line | PO BOX 90010
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City | BOWLING GREEN
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State | KY
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Zip | 42102-9010
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Country | US
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Telephone | 270-745-1100
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Fax | 270-745-1156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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