Individual provider · Type 1 NPI

Theresa A. Clark, RDN/LDN, CSP

Pediatric Nutrition Registered Dietitian · Orlando, FL

NPI number 1013882174 Active

Practice location

615 E Princeton St Ste 104
Orlando, FL 32803-1435

Call (407) 303-6920 Map

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nutrition Registered Dietitian Primary 133VN1004X10481 (FL)

Pediatric Nutrition Registered Dietitian: An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, educatio…

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About NPI 1013882174

Theresa A. Clark, RDN/LDN, CSP's National Provider Identifier is 1013882174, issued on Oct 8, 2025. The primary taxonomy on file is Pediatric Nutrition Registered Dietitian (133VN1004X), and the practice location is in Orlando, FL. The record was last updated on Oct 8, 2025.