Provider Demographics
NPI:1386113736
Name:TOCZEK, TAMI LYNN (RDN)
Entity type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:LYNN
Last Name:TOCZEK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:TAMI
Other - Middle Name:LYNN
Other - Last Name:WEISBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:SD
Mailing Address - Zip Code:57551
Mailing Address - Country:US
Mailing Address - Phone:308-360-1348
Mailing Address - Fax:
Practice Address - Street 1:22013 OLD HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:SD
Practice Address - Zip Code:57551
Practice Address - Country:US
Practice Address - Phone:308-360-1348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86077159133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered