Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Theresa A Clark, RDN/LDN, CSP

Individual provider Pediatric Nutrition Registered Dietitian · NPI 1013882174

Theresa A Clark, RDN/LDN, CSP is a Pediatric Nutrition Registered Dietitian in Orlando, Florida. Licensed in Florida. Registered with an NPI since 2025.

Licensed in
FL
In the registry since
2025

Practice location Address checks out

615 E Princeton St Ste 104
Orlando, FL 32803-1435
Phone: (407) 303-6920
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nutrition Registered Dietitian (primary) Taxonomy 133VN1004X · Licence 10481 (FL)

Record details

NPI number1013882174
Entity typeIndividual (Type 1)
GenderFemale
Credentials RDN/LDN , CSP
Sole proprietorNo
NPI enumeratedOctober 8, 2025
Last updated in NPPESOctober 8, 2025
Certification dateOctober 8, 2025

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