NPI 1376469767 · live from the CMS NPI Registry
Tainara Benassi Lourenco, RDN
Dietitian, Registered in Walled Lake, MI. National Provider Identifier 1376469767, active.
NPI record
| NPI | 1376469767 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 606 Pointe Dr, Walled Lake, MI 48390 |
| Practice phone | 248-561-7264 |
| Enumerated | June 29, 2026 |
| Last updated | June 29, 2026 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 86414641 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.