Provider Demographics
NPI:1669692000
Name:TOWNSEND, JOANNA ELAINE (RD, CDE)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:ELAINE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 W RAY RD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3524
Mailing Address - Country:US
Mailing Address - Phone:480-855-6075
Mailing Address - Fax:888-237-7954
Practice Address - Street 1:2875 W RAY RD
Practice Address - Street 2:SUITE 16
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3524
Practice Address - Country:US
Practice Address - Phone:480-855-6075
Practice Address - Fax:888-237-7954
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL916154133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX916154OtherCOMMISSION ON DIETETIC REGISTRATION
TX2052-0444OtherNATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS