Healthcare Provider Details

I. General information

NPI: 1437468568
Provider Name (Legal Business Name): DANIELLE AUTUMN DALTON R.D./L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD STE D436
MOBILE AL
36608-6705
US

IV. Provider business mailing address

PO BOX 36258
BELFAST ME
04915-1204
US

V. Phone/Fax

Practice location:
  • Phone: 251-266-1987
  • Fax: 251-266-2070
Mailing address:
  • Phone: 251-318-2678
  • Fax: 251-405-9900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1192
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number5280
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: