Provider Demographics
NPI:1588479448
Name:TAWIL, MARIE THERESE (RDN)
Entity type:Individual
Prefix:
First Name:MARIE THERESE
Middle Name:
Last Name:TAWIL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:TERY
Other - Middle Name:
Other - Last Name:TAWIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2653 W IVANHOE ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2653 W IVANHOE ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3429
Practice Address - Country:US
Practice Address - Phone:480-406-4669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered