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THERESA A CLARK RDN/LDN, CSP
NPI 1013882174
Dietitian, Registered - Nutrition, Pediatric in Orlando, FL

Active since October 08, 2025
615 E PRINCETON ST STE 104, ORLANDO, FL 32803(407) 303-6920 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Theresa A Clark Rdn/ldn, Csp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA A CLARK RDN/LDN, CSP (NPI 1013882174) is an individual nutrition, pediatric provider in Orlando, Florida, licensed in Florida (10481) and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1013882174
Entity TypeIndividualFemale
Primary Taxonomy133VN1004X
Provider Legal NameTHERESA A CLARKCredential: RDN/LDN, CSP
Location Address615 E PRINCETON ST STE 104Orlando, FL 32803-1435
Mailing Address615 E Princeton St Ste 104Orlando, FL 32803-1435
Phone(407) 303-6920
Sole ProprietorNo
Enumeration DateOctober 8, 2025
NPPES CertifiedOctober 8, 2025
✔ NPI 1013882174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, Registered · Nutrition, PediatricDietary & Nutritional Service Providers
Taxonomy Code133VN1004X
License✔ Licensed in FL · 10481
Definition
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, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition.
615 E PRINCETON ST STE 104, Orlando, FL 32803
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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH MICHELLE GRANGER MS, CCC-SLP
Speech-Language Pathologist
615 E PRINCETON ST STE 104
ORLANDO, FL 32803
Orange County (407) 303-1575
EMILY NICOLE HOUCHENS
Occupational Therapist
615 E PRINCETON ST STE 104
ORLANDO, FL 32803
Orange County (407) 303-1564
DR. LILIAN VICTORIA ABLAN ROLDAN MD
Pediatrics
615 E PRINCETON ST STE 104
ORLANDO, FL 32803
Orange County (407) 303-6920
MRS. CHRISTINE CAVENDER MOT
Occupational Therapist
615 E PRINCETON ST STE 104
ORLANDO, FL 32803
Orange County (407) 303-1575
BAILEY MARQUIS
Speech-Language Pathologist
615 E PRINCETON ST STE 104
ORLANDO, FL 32803
Orange County (407) 303-1575
ALYSSA GEZILLE CRUZ
Registered Nurse
615 E PRINCETON ST STE 104
ORLANDO, FL 32803
Orange County (407) 303-6920
MS. RACHEL DANIELLE FISHER MD
Pediatrics (Hospice and Palliative Medicine)
615 E PRINCETON ST STE 104
ORLANDO, FL 32803
Orange County (407) 303-6920

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Clark's NPI number?

The NPI number for Theresa Clark is 1013882174. It was assigned to this individual provider in the NPPES registry on October 8, 2025.

Where is Theresa Clark located?

Theresa Clark practices at 615 E Princeton St Ste 104, Orlando, FL 32803. The listed phone number is (407) 303-6920.

What is Theresa Clark's specialty?

The primary specialty registered for this NPI is Dietitian, Registered, specializing in Nutrition, Pediatric, with taxonomy code 133VN1004X.

When was this NPI record last updated?

The NPPES record for Theresa Clark was last updated on October 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.