Provider Demographics
NPI:1487964425
Name:INSETTA, TERESA LOUISE (MSRD)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:LOUISE
Last Name:INSETTA
Suffix:
Gender:F
Credentials:MSRD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 OGLETOWN-STANTON ROAD
Mailing Address - Street 2:CHRISTIANA CARE HIGH SCHOOL WELLNESS CENTERS
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718
Mailing Address - Country:US
Mailing Address - Phone:302-477-3960
Mailing Address - Fax:
Practice Address - Street 1:2501 EBRIGHT ROAD
Practice Address - Street 2:CONCORD HIGH SCHOOL WELLNESS CENTER
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-1198
Practice Address - Country:US
Practice Address - Phone:302-477-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDN-0000370133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEDN-0000370OtherPROFESSIONAL LICENSE