Provider Demographics
NPI:1962875427
Name:TOCHER, SUSAN TERESA (RD, LD)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:TERESA
Last Name:TOCHER
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 1:1110 W PEACHTREE ST NW STE 1100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3609
Mailing Address - Country:US
Mailing Address - Phone:404-892-2131
Mailing Address - Fax:404-215-9222
Practice Address - Street 1:684 SIXES RD STE 265
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30115-8720
Practice Address - Country:US
Practice Address - Phone:770-720-2221
Practice Address - Fax:770-720-2282
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD001845133V00000X
GA806421133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA806421OtherRDN
GA001845OtherLICENSED DIETITIAN