Healthcare Provider Details

I. General information

NPI: 1992328546
Provider Name (Legal Business Name): CAROLINE COHEN PHD, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 11TH AVE S STE 410
BIRMINGHAM AL
35205-3423
US

IV. Provider business mailing address

4036 ROYAL OAK CT
MOUNTAIN BRK AL
35243-5818
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-9700
  • Fax:
Mailing address:
  • Phone: 205-613-5554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number2535
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2535
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: