Provider Demographics
NPI:1588733778
Name:TAMBORSKI, MARY F (RD , LD)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:F
Last Name:TAMBORSKI
Suffix:
Gender:F
Credentials:RD , LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-8514
Mailing Address - Country:US
Mailing Address - Phone:937-393-4899
Mailing Address - Fax:937-393-4996
Practice Address - Street 1:1402 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-8514
Practice Address - Country:US
Practice Address - Phone:937-393-4899
Practice Address - Fax:937-393-4996
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5023133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered